- What exactly is male impotence?
- How common is impotence?
- Is impotence usually psychological, or "all
in your head"?
- How can you determine what my specific problem
- Is any testing required?
- If my problem is psychological, what kind of
treatment is available?
- What about male hormone "testosterone" shots
- What are some other treatments?
- I want sex to be natural and as spontaneous
as possible. Are any other treatment options available?
- What is injection therapy?
- You mentioned penile implants, tell me more?
- How safe are penile implants?
- Have you implanted many men?
| 1). Q.
What exactly is male impotence?
A. Impotence means that a man is unable to have a
penile erection of satisfactory firmness or duration for
normal sexual activity.
2). Q. How common is impotence?
A. Approximately 30 million men in the US are impotent.
Many men are embarrassed to seek treatment, and some are
not aware that impotence can be successfully treated in
almost all cases.
3). Q. Is impotence usually psychological,
or "all in your head"?
A. Impotence is most often due to physical (organic)
causes. Few men have purely psychological impotence.
4). Q.How can you determine what
my specific problem is?
A. At the first visit, we will obtain your medical
and sexual history and perform a urological examination.
Additional studies may also be recommended.
5). Q. Is any testing required?
A. Blood and urine tests are often needed to measure
your hormone levels and to check for diabetes and prostate
cancer. Measurement of your sleep erections, penile blood
flow and nerves related to sexual activity may also be ordered.
6). Q. If my problem is psychological,
what kind of treatment is available?
A. Counseling is often prescribed. Sex therapy or
psychotherapy may be appropriate. If this doesn't work,
or the patient does not wish sex therapy or psychotherapy,
other treatments are available with a high success rate.
7). Q. What about male hormone "testosterone"
shots or patches?
A. Male hormone supplements only help if your hormone
level is low. Most men have normal male hormone levels.
8). Q. What are some other treatments?
A. In 1997, the FDA approved the use of intraurethral
inserts of Prostaglandin E-1 (Muse) which gets absorbed
through the urethra directly into the erectile chambers
resulting in an erection. Many men will find it a satisfactory
treatment. In 1998, the FDA approved the use of Sildenafil
(Viagra) as the first oral treatment for impotence. This
very popular treatment choice has an approximate 60% success
rate for organic impotence and about a 90% success rate
for psychogenic impotence.
Vacuum tumescence/constriction devices are available, but
they do not produce a rigid erection in many men. They may
also interfere with ejaculation, and are cumbersome to use.
9). Q. I want sex to be natural and
as spontaneous as possible. Are any other treatment options
A. Penile implants give the most rigid and reliable
erection and can be used as often as you like. Other possible
options include penile vascular surgery and penile injection
therapy. Penile vascular surgery is rarely indicated.
10). Q. What is injection therapy?
A. There are certain medications such as Prostaglandin
E-1 (Caverject) which can induce an erection when
injected into the penis. You must inject everytime you want
an erection. Many men find this very satisfactory.
11). Q. You mentioned penile implants,
tell me more?
A. Penile implants
have been available for more than 20 years. There are
several non-inflatable and inflatable types. All implants
are completely internal. After you have healed, the genitalia
look normal and most men and their partners are not aware
of the implant. The implant gives an excellent, reliable
erection and the inflatable models give a natural-appearing
penis when inflated and deflated. The success rate of penile
implantation is over 90%.
12). Q. How safe are penile implants?
A. The complication rate is low. Many men with diabetes
and heart disease (frequently present in men with impotence)
can tolerate this procedure if they are properly evaluated
and treated beforehand. For most men, this is an ambulatory
procedure not requiring an overnight hospital stay.
13). Q. Have you implanted many
A. Over the last 30 years, I have implanted more
than 1,000 men and have taught urologists how to perform
the surgery and have demonstrated this surgery abroad. I
have also lectured and written textbook chapters on the
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the Association for Male Sexual Dysfunction
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are for informational purposes only. The content
is not intended to be a substitute for professional
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