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Male Sexual Dysfunction, Viagra and Penile Implant Surgery by Phalloplasty Surgeon Surgeon E. Douglas Whitehead, M.D.
Dr. Whitehead, a phalloplasty augmentation surgeon, specializes in male sexual dysfunction and penile implant surgery. Click here for information about male sexual dysfunction the causes and treatments.
What is Male Sexual Dysfunction?
Problems with:
  • Erections
  • Ejaculatory difficulties
  • Unsatisfactory levels of sexual activity
  • Low sexual desire
Specifically, such dysfunctions are:
  • Impotence
  • Premature ejaculation
  • Retarded ejaculation
  • Marital problems
These may occur in single or married men of all age groups.

What causes Male Sexual Dysfunction?
Current medical research indicates that in approximately 80% of men the problem is due to physical causes. These include: Physical Causes:
  • Diabetes
  • Side effects from medication, particularly blood pressure and antidepressant medications
  • Atherosclerosis
  • Hypertension
  • Hormonal disorders
  • Alcohol
  • Recreational drugs
  • Neurological illness or injury
  • Metabolic diseases
  • Kidney diseases
  • Structural genital problems
  • Abdominal, pelvic or genital surgery
  • Smoking
Psychological Causes:
  • Performance anxiety
  • Fear of intimacy
  • Stress
  • Marital problems
  • Anxiety
  • Depression

Diagnostic Testing
Diagnostic testing employed by the Association utilizing new and sophisticated methods to determine the cause of the dysfunction are:
  • Penile Arterial Blood Flow Studies

    • to measure if enough blood is delivered to the penis during an erection
    • Duplex Doppler Ultrasound
    • Intracavernous Vasoactive Agents (Pharmacologic stimulation)
    • Penile Plethysmography
    • Pudendal Arteriography
  • Venous Studies

    • to identify an abnormal leak causing premature softening of the penis
    • Cavernosometry
    • Cavernosography
  • Neurological Studies

    • to determine if the nerves involved with the erections are functioning normally
    • Biothesiometry
    • Stimulus Evoked Response
    • Electromyography
  • Sleep Studies

    • to determine if the impotence is due to physical or psychological factors
    • Nocturnal Penile Tumescence (NPT) and Rigidity Testing, using the ambulatory RigiScan method
  • Hormonal Studies

    • to determine if there are abnormal hormonal levels
    • Testosterone
    • Prolactin
    • LH
    • FSH
    • Thyroid and adrenal studies
The selection of diagnostic studies is made with the patient's specific problem and his desires considered. The patient's partner is encouraged to participate in the evaluation and treatment selection. Most men do not require all of the above tests. Appropriate treatment choices are reviewed and selected based on the patient's wishes.

Treatment Approaches Medical Treatments With the development of advanced medical techniques, approximately 90% of patients of all ages are helped without surgery.

  1. Oral Medication: Sildenafil (Viagra), Vardenafil (Levitra), and Tadalafil (Cialis) are FDA approved medications for erectile dysfunction.  Erection occurs after arousal.
  2. Intraurethral Insert: Prostaglandin E-1/Alprostadil (Muse) is a new FDA approved intraurethral insert that provides an erection.
  3. Vacuum Erection Device: an external device that is used to get an erection
  4. Intracavernosal Pharmacologic Agents: a painless self-injection into the penis of one or a combination of Papavarine, Phentolamine, Prostaglandin E-1 just before an erection is desired.
  5. Endocrine Therapy: topical patches or injectable treatment for a hormonal condition.
Surgical Treatments
  1. Penile Implant: an internal device that is permanent and makes the penis hard enough for penetration. There are several types with different features. With the currently available state-of-the-art implants, a success rate of almost 95% may be expected.
  2. Penile Arterialization: rerouting blood to the penis
  3. Venous Ligation: tying off leaky veins.
    Treatment for Psychogenic Dysfunction for Individuals and Couples
  1. Marital and Family Therapy
  2. Sex Therapy
  3. Psychotherapy
  4. Psychopharmacotherapy
  5. Intraurethral Insert (Muse)
  6. Prostaglandin E-1 (Caverject)
  7. Sildenafil (Viagra), Vardenafil (Levitra), and Tadalafil (Cialis)
For more information, please read our articles page and the Book titled "Viagra - The Wonder Drug for Peak Performance" by Dr. Whitehead and published by Dell Publishing, 1999

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Disclaimer: The content, illustrations and references to male sexual dysfunction, Viagra, penile implants and penis enlargement in this website are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis or treatment.