OK guys … you’ve set the mood for romance with wine, flowers, music and candles, but when the time comes something happens – or doesn’t happen – and you end the night unhappy. If you’ve had this experience, you are not alone. Nearly 30 million men in the United States suffer from some form of erectile dysfunction, according to the National Institutes of Health.
ED can be frustrating, embarrassing, even depressing, but, fortunately, it can also be successfully treated.
“There is absolutely no reason to suffer with the anxiety and disappointment brought on by ED because it is totally curable,” said Dr. Roy Carrington Mason, a urologist with Cleveland Clinic Indian River Hospital. “There is a solution readily available. But the cure starts with a physical evaluation from your physician, preferably a prosthetic urologist who has access to all the technology available to fix this problem.”
Erectile dysfunction (ED), often referred to as impotence, is a common medical condition that is characterized by the inability to achieve or maintain an erection sufficient for intercourse.
“There is no single smoking gun cause of the condition,” Dr. Mason said. “ED can affect men in their 20s all the way to their 90s. It’s a collection of different things from premature ejaculation to erectile failure. Hypertension, diabetes, smoking, vascular disease and alcohol are contributing factors. Sometimes there are psychological components as well, and many times medications like antidepressants have side effects that can lead to erectile difficulty.”
According to Dr. Mason, about 70 percent of all ED cases can be treated and cured with PDE5 inhibitors in a pill form, the most common being branded as Viagra, Cialis and Levitra. These pills enhance the blood flow to the penis, enabling it to function properly.
“In my practice I like to try the oral medications first,” Dr. Mason said. “The pills are generic now and inexpensive. They’ve been around for decades and are very safe. If the patient doesn’t respond to those we check their testosterone levels and optimize them.
“Testosterone is not in itself a treatment for ED, however. It only impacts the desire that is necessary for proper sexual function but not the actual function of the penis.”
There are several options to correct ED if oral medications and testosterone don’t get the job done.
A vacuum erection device, sometimes called a vacuum pump or penis pump, is an external acrylic pump that a man uses to get and maintain an erection. The device consists of a cylinder that goes over the penis with either a battery-operated or manual pump that causes the blood to rush into the penis, creating an erection. A band placed at the base of the penis helps keep the penis engorged. The band can be kept in place for about 30 minutes during intercourse.
There are also penile injections, “which are prescription medicines that the patient injects directly into his penis five to 10 minutes before sexual intercourse, causing an erection that will generally last about 30 minutes,” Dr. Mason explained. “The dosage can be regulated so that the erection lasts long enough for everyone to be satisfied but it’s important to follow those guidelines. An erection lasting more than four hours can be painful and require a trip to the emergency room.”
Penile implants are a more permanent solution to erectile dysfunction. According to Cleveland Clinic, there are two types of penile implants that can be surgically implanted to help you get an erection.
The inflatable penile implant is a pump in your scrotum that allows you to get an erection whenever you choose. The implant consists of two cylinders, a reservoir and a pump that are surgically placed in your body. The cylinders are inserted into the penis with tubes connecting them to a separate reservoir under the lower abdominal muscles. The reservoir contains fluid. A pump positioned under the loose skin of the scrotum is also connected to the system.
To inflate the implant, you press the pump in your scrotum. The pump transfers fluid from the reservoir to the cylinders in your penis, inflating them to the level of hardness that you want. Once erect, the erection can be maintained for as long as you wish, even after an orgasm. When you want to stop being erect, pressing the valve on the pump returns the fluid to the reservoir which deflates the penis.
A non-inflatable penile implant consists of bendable silicone rods in the erection chambers of your penis that allow you to extend the rods into an erect position. To use the implant, you press on the penis to extend the rod into position. It too can be used in the erected position for as long as you like. After using the implant, you press on your penis again to push it back down.
“Think of penile implants as reconstructing the hydraulics that cause erection,” Dr. Mason continued. “These implants are inserted during a 30-to-40-minute procedure under general anesthesia and the patient can go home the same day. They are completely concealed inside the body and not at all visible. A penile implant reproduces a natural response and feels the same as a normal erection for both partners. They do not feel like they are utilizing a mechanical device at all. There is a 96.7 percent satisfaction rate among penile implant recipients and the device can last indefinitely.”
Dr. Mason stresses that a man cannot choose the size of his penile implant like a woman can a breast implant. “The patient’s body tells us what size implant we use. Our ability is to make what they have functional, not to enhance their size.”
Erectile dysfunction can have a profound impact on the quality of life for those affected but it is not a reflection of one’s masculinity or self-worth. Fortunately, with the right approach, including lifestyle changes, psychological support and medical interventions, most men can overcome this condition and regain a fulfilling sex life.
Dr. Mason received his medical degree from the University of North Texas Science Center – Texas College of Osteopathic Medicine and completed his residency at LSU/Ochsner clinic in New Orleans. His office is located at Cleveland Clinic’s Health and Wellness Center, 3450 11th Court, Vero Beach. Call 772-794-9771.