Surgical Interventions For Men With Erectile Dysfunction
|
Vascular Surgery
Penile arterial revascularization is only appropriate in young patients with demonstrable arteriogenic erectile dysfunction due to congenital vascular anomalies or traumatic injuries to the pudendal or penile arteries (e.g., after road traffic accidents).
Prostheses
There are three forms of penile prostheses available: semi-rigid, malleable, and inflatable. Typical candidates for a penile implant are patients with chronic disease states such as long-term diabetes and end-organ failure or severe arteriogenic impotence combined with severe veno-occlusive dysfunction and men with treatment unresponsive Peyronie’s disease in combination with erectile dysfunction. Typical complications of prosthetic surgery are infections (1–5%) and mechanical failures (10–20%)
Special Situations Requiring Interventions For Men With Erectile Dysfunction
Depression and Serotonin Reuptake Inhibitors
Sexual dysfunction associated with the use of serotonin reuptake inhibitors has been reported in 30–70% of treated patients and is a significant contributor to discontinuation of these medications. A review of selective phosphodiesterase type-5 inhibitors for antidepressant-associated sexual dysfunction suggests treatmet of this side effect of antidepressant medication could improve depression disease management outcomes.
Testosterone Deficiency
Androgen replacement can improve libido, erection rigidity, and sexual satisfaction in men with demonstrable low serum levels of testosterone. In a large cohort of 1461 men presenting with erectile dysfunction, just over one-sixth (17.7%) at initial screening had biochemical evidence to suggest the possibility of hypogonadism. More rigorous estimation of serum testosterone, associated parameters, and the presence of clinical symptoms resulted in 3% of the population having a diagnosis of hypergonadotropic hypogonadism. Of these, one-fifth agreed to a trial of testosterone therapy but two-thirds of this eligible group also required another erectogenic agent to resolve the erectile dysfunction.
Treatment can be with daily 5 mg transdermal patches or gel or 250 mg intramuscular injection three times weekly. The dose may need adjustment depending on clinical and biochemical response. Monitoring of hematocrit, liver, prostate, and lipid parameters is mandatory.
Conclusion
Erectile dysfunction is the most commonly presenting male sexual problem to clinicians. A thorough assessment of possible etiological factors and consideration of psychological, couple, and physical factors in the management of this disorder will allow sufferers of the condition an excellent opportunity for amelioration of the symptom. In many instances reassurance, educational advice, and the use of a PDE5 inhibitor will be sufficient as first line management of the condition. |
|
Author Resource:-
David Crawford is the CEO and owner of a Penis Enlargement Pills company known as Male Enhancement Group which is dedicated to researching and comparing male enhancement products in order to determine which male enhancement product is safer and more effective than other products on the market. Copyright 2010 David Crawford of Vigrx Plus Reviews This article may be freely distributed if this resource box stays attached.
|
By :
Daviedon Crawfordons
Submitted
2010-10-02 01:36:33 |
Article From Article Mayhem
 Ezine ready view |
|
|
|
Related Articles
|
|
|
![[Valid RSS feed]](http://www.articlemayhem.com/images/icon_Rss.png "XML Feed For RSS"){kind=icon}
Category Rss Feed![[Valid RSS feed]](http://www.articlemayhem.com/images/rss.jpg "XML Feed For RSS")