Sexual Problems in Men

  • Medical Author:
    Kevin C. Zorn, MD, FRCSC, FACS

    Dr. Kevin Zorn is a dual-board-certified (US and Canada), minimally-invasive uro-oncology, fellowship trained urologist at the University of Chicago. His main focus of clinical and scientific interest is in the surgical treatment of renal and prostate cancer. He is also an expert in performing surgery with the DaVinci Surgical Robotic System to manage localized prostate cancer and small renal masses. Dr. Zorn studied medicine and urology at McGill University in Montréal.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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What are surgical treatments for erectile dysfunction?

There are numerous surgical treatments available for erectile dysfunction.

Penile vascular surgery

Bypass surgery can be performed when there is an isolated artery occlusion disrupting blood flow in the penis. With any surgical procedure, it's necessary to consider the patient's surgical risk. Not all patients will be able to qualify for this type of intervention.

Prosthesis

Various types of prosthesis are available -- malleable, mechanical, and inflatable. The patient should discuss the type he would prefer with his physician. The majority of prostheses will need replacement after 10 to 15 years. Surgical complications include infection, mechanical failure, cylinder leaks, perforation, penile shortening, autoinflation, and pain.

What is premature ejaculation?

Premature ejaculation is the most common of the ejaculatory disorders; approximately 20% to 30% of men will have premature ejaculation. Ejaculation problems involve the improper discharge of sperm, prostatic, and seminal vesicle fluid through the urethra.

There are three different types of premature ejaculation:

  • Premature ejaculation is ejaculation after minimal or no physical stimulation.
  • Retarded ejaculation is ejaculation after a long delay of physical stimulation.
  • Retrograde ejaculation is orgasm without ejaculation, also called "dry" ejaculation.

What causes premature ejaculation?

There are many potential causes of premature ejaculation. These include neurological causes that affect the following areas:

  • Central control of ejaculation
  • Innervations to the seminal tract
  • Sensory innervation to the genitalia/prostate

Premature ejaculation may be caused by negative conditioning and penile hypersensitivity. Retarded ejaculation may be an early sign of diabetes or may develop following surgery for benign prostatic hyperplasia (BPH). Anejaculation (retrograde ejaculation) may be caused by radical prostatectomy, cystoprostatectomy (removal of the bladder and the rectum), or the use of certain medications such as alpha-blockers (tamsulosin) and antidepressants (SSRIs).

Medically Reviewed by a Doctor on 3/2/2016
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