Erectile dysfunction and prostate problems often start at the same age. Television has made Viagra, Levitra and Cialis well known treatments for male sexual problems. What is not generally known in the public’s mind are the actual mechanics of erection. Erection occurs when the penis becomes filled with blood pumped in through the arteries and entrapped within special chambers in the penis. Simultaneous slowing of the venous drainage of blood from these chambers, essential to maintain the rigidity of an erection is accomplished by an ingenious hydraulic system involving compressive obstruction of these drainage veins caused by the actual bulk of the engorged chambers themselves.
Erectile dysfunction can therefore be related not only to insufficient arterial supply but also to an abnormal increase in venous drainage, often referred to as a venous leak. When impotency, is related to a poor arterial blood supply caused by atherosclerotic vascular disease, (hardening of the arteries), the physician must keep in mind that this is the same disease that interferes with blood flow through the coronary arteries in the patient’s heart. The careful clinician will view E.D. as a reason to investigate and the intelligent patient will not stand in the way of his doctor doing these investigations.
E.D. is a warning sign of silent vascular disease and bringing it to the doctor’s attention may very well result in avoiding serious cardiovascular problems such as a heart attack or a stroke.
There are other causes of impotency: Neurological disease, diabetes, bicycle riding, pelvic trauma or surgery. Less frequently, insufficient testosterone is the cause. Emotionally based impotency, once thought to be the most common cause is now understood to rarely be the primary cause but rather the result of impotency.
Many drugs used to treat high blood pressure, depression, insomnia, anxiety, pain, allergies, and prostate cancer can also have an adverse effect on potency. Finally, drug abuse involving alcohol, marijuana or tobacco can result in E.D. As a man ages, he notices that the occasional episode of impotency, now occurs more frequently. Nocturnal emissions (wet dreams) and morning erections occur less often. Difficulty in achieving sufficient penile rigidity to penetrate or maintain erection throughout intercourse increases. Some are unable to delay orgasm long enough to satisfy their partners while others may not be able to reach a climax no matter how long they try.
Once the cause has been established, treatment can start. Treatment options include medication, given orally, applied to the skin, inserted into the urethra, or injected into the penis. The pump vacuum device and surgical prosthesis implantation into the penis have all been used with success. Erectile dysfunction follows prostate surgery in a significant percentage of cases. Fortunately, microwave thermotherapy for prostate enlargement doesn’t carry the same degree of adverse consequences and a recent clinical study actually indicated a measureable improvement in sexual functioning following its use.
Question? Call Dr. Okun 718-241-6767
