Erectile Dysfunction (ED, Impotence) (cont.)

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What about psychological therapy for erectile dysfunction?

Experts often treat psychologically based impotence using techniques that decrease anxiety associated with intercourse. The patient's partner can help apply the techniques, which include gradual development of intimacy and stimulation. Such techniques also can help relieve anxiety when physical impotence is being treated. If these simple behavioral methods at home are ineffective, referral to a sex counselor may be advised.

Surgery for erectile dysfunction

Surgery for erectile dysfunction may have the following as its goal:

  1. To implant a device that causes the penis to become erect
  2. To reconstruct arteries in order to increase the flow of blood to the penis
  3. To block veins that drain blood from the penis

Implantable devices, known as prostheses, can allow erections in many men with impotence.

Malleable implants usually consist of paired rods, which are inserted surgically into the corpora cavernosa, the twin chambers exercising the length of the penis. The user manually adjusts the position of the penis and, therefore, the rods. Adjustment does not affect the width or length of the penis.

Inflatable implants consist of paired cylinders, which are surgically inserted inside the penis and can be expanded using pressurized fluid (see figure 3). Tubes connect the cylinders to a fluid reservoir and pump, which also are surgically implanted. The patient inflates the cylinders by pressing on the small pump, located under the skin in the scrotum. Inflatable implants can expand the length and width of the penis somewhat. They also leave the penis in a more natural state when not inflated.

Possible problems with prostheses include mechanical breakdown and infection. Mechanical problems have diminished in recent years because of technological advances.

Picture of an inflatable implant for erectile dysfunction
Picture of an inflatable implant for erectile dysfunction; SOURCE: NIH

Surgery to repair arteries (penile arterial reconstructive surgery) can reduce impotence caused by obstructions that block the flow of blood to the penis. The best candidates for such surgery are young men with discrete blockage of an artery because of a physical injury to the pubic area or a fracture of the pelvis. The procedure is less successful in older men with widespread blockage of arteries.

Medically Reviewed by a Doctor on 4/23/2015

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