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Endocrine abnormalities can cause significant abnormalities in sexual function that can be corrected and restored. Male hormone deficiency is common with age, but there is no controversy about hormone replacement therapy, and there is no evidence that external testosterone supplies or restores erectile function in erectile dysfunction patients with normal androgen levels. .
- Arterial Erectile Dysfunction Due to Injury
Surgically increasing the supply of arterial blood to the penis is not widely used due to the low survival rate of the surgical vessels.
- Sexual Psychology / Relationship Therapy
It is mainly used for the treatment of erectile dysfunction due to psychological causes.
- Oral Medication-PDE5 Inhibitor
It increases the arterial blood in the corpus cavernosum, causing the relaxation of smooth muscle and erection of the penis. These drugs have been proven to be safe and effective not only for general erectile dysfunction but also for patients with special conditions of erectile dysfunction, such as diabetes and prostate extraction. Be careful when taking this medication because PDE5 inhibitors are not inducers of erections and require sexual stimulation to induce erections. Typically, sexual success is about 75%. However, nitrogen organics (nitroglycerin, isosorbide) and other nitrogenous preparations should be used with PDE5 inhibitors as absolute contraindications, which can cause unpredictable severe hypotension and fatal consequences. It should also be used with patients who have angina or severe arrhythmia within 6 months or who have myocardial infarction.
- Vacuum Erection Mechanism
The principle of the vacuum erection mechanism is so simple that the cylinder is placed on the penis and the negative pressure is generated by the air pump. After compressing the base of the penis with a compression ring, an erection is maintained. Regardless of the cause of erectile dysfunction, it is effective. Most of the side effects are local pain, bruising and difficulty ejaculation, and sometimes the partner complains of the cold of the penis.
- Intracavernosal Injection
The most effective method of erectile dysfunction is a high success rate in most patients. It is also effective in patients with spinal cord injuries, extensive prostatectomy, or pelvic pelvic surgery because the nerves do not need to be normal. 2-3 visits are required to determine the initial dose and to teach you how to use it.
- Penis Implants
This is done in patients who do not respond to other treatments, do not want to use external instruments, or have severe penile deformities. By inserting implants instead of spongy bodies on both sides of the penis to create an erection, it removes and inserts the spongy bodies in the penis.
Non-expansion type is a device that can bend and release the penis just because the penis is erect in normal times, and the expansion type is a device that puts water into the penis with a pump in the scrotum when you want an erection and relieves erection after use. Surgery is needed, the risk of infection is high, and it is expensive, but satisfaction is very high, reaching 90%.
Many patients still do not receive adequate care and treatment for erectile dysfunction. Therefore, it is important to recognize that oral medications can provide a healthy sexual life by providing about 75% of therapeutic effects and providing other ED treatment meds to patients who do not respond. This can help patients live actively and actively.
- Treatment of Erectile Dysfunction after extensive prostatectomy: Sexual Rehabilitation
After extensive prostatectomy, the incidence of erectile dysfunction is very high and it is thought to be mainly due to nerve damage. It is known that the recovery of nerves takes about 6 months to 2 years. During this period, the cavernous smooth muscle is fabricated and replaced with collagen, resulting in permanent erectile dysfunction even after the nerve is restored. Recently, sexual rehabilitation programs have been implemented to supply oxygen to the penile sponges and preserve tissues by using drugs or vacuum devices 2-3 times a week. In 19% of patients who do not have sexual rehabilitation, the erection recovers, compared with 52% of patients who have rehabilitation.
