IMPOTENCE

About the Condition

Impotence is the inability to achieve and/or maintain an erection of the penis for satisfactory sexual intercourse and is correctly referred to as erectile dysfunction (ED).

Symptoms and Detection

Erectile dysfunction pattern includes:-

• the occasional inability to achieve an erection
• the inability to maintain an erection during sexual intercourse
• the complete inability to achieve an erection

Screening and Testing

Blood tests may be carried out to check on the level of male hormones in the blood and to check for other medical problems that cause erectile dysfunction. Other tests that may be performed include:-

• Ultrasonography

  This helps determine if the blood circulation to the genitals is sufficient for an erection.

• Neurological tests

  A physical examination is performed to check if there is any nerve damage.

• Blood pressure tests

  A dye is injected in the blood vessels so that your doctor could determine if there are any abonormalities in the flow of blood through the penis.

Risk Factors and Causes

The causes of erectile dysfunction may be physical or psychological.

Physical causes include:

• cardiovascular disorders affecting blood supply to the penis
• nerve damage
• hormonal disorders
• a physical abnormality of the penis
• certain prescription drugs
• drug abuse

Psychological causes include:

• depression
• stress
• performance anxiety
• traumatic experiences

Prevention

Steps that can be taken to reduce the possibility of erectile dysfunction are:-

• limiting the use of alcohol or drugs
• not smoking
• maintaining a healthy lifestyle
• maintaining good mental health (reducing stress, dealing with anxiety and depression)

Treatment Options

The treatment options, once psychological causes have been ruled out, are:-

1. Oral therapy

   Sildenafil (Viagra) may be prescribed. The medication enhances the ability to attain and maintain an erection in up to 60% of trial subjects. Patients will be advised to comply strictly with the prescription recommendations, especially for persons with heart problems

2. Intracavernosal injections

   Prostaglandin E1 (Alprostadil) is self-injected by the patient to achieve an erection. There are risks involved, including prolonged erection and formation of fibrous tissue at the site of injection.

3. Trans-urethral agents

   This involves the delivery of a pellet of Prostaglandin E1 Alprostadil) into the urethra.

4. External suction devices

   This involves the use of suction devices to pull blood into the penis so as to attain and maintain an erection for intercourse.

5. Surgery

   Penile prosthesis (implants) can be fitted for selected patients. Vascular ligature is performed in patients with blood flow problems causing erectile dysfunction.