Impotence (ED) (cont.)
Surgery for erectile dysfunction
Surgery for erectile dysfunction may have as its goal:
- To implant a device that causes the penis to become
erect;
- To reconstruct arteries in order to increase the flow
of blood to the penis, or
- To block veins that drain blood from the penis.
Implantable devices, known as prostheses, can cause erections in many men
with impotence.
Malleable implants usually consist of paired rods, which are inserted
surgically into the corpora cavernosa, the twin chambers running 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.
Surgery to repair arteries 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.
What about psychological therapy?
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.
Next: What will the future bring for erectile dysfunction? »
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