In PACE Hospitals, Andrology department deals with male health, particularly relating to the problems of the male infertility and impotence and urological problems that are unique to men. It is the counterpart to gynaecology, which deals with medical issues which are specific to the female reproductive system. Aided by state-of-the-art equipment, highly qualified consultants and surgeons.
- Impotence (Erectile Dysfunction): Impotence is the chronic inability to have an erection that is rigid enough, and that can be sustained for a long enough period, to complete sexual intercourse for at least half of the times sexual intercourse takes place. Erectile dysfunction is a common, treatable condition
- Male Infertility
Diagnosis & Tests
- For Impotence
A man’s inability to have and maintain an erection can be caused by many disorders. The causes can be either physical or psychological and the resulting impotence can be categorised as physical impotence and psychological impotence respectively:
- Physical Impotence: may result from damage to the nerves or the blood vessels that control the flow of blood to the penis. It may also be caused by problems with hormones – substances in the bloodstream that affect or control the activity of some organs
- Psychological Impotence: can be the result of fear, stress, worry, anger or frustration. Often, this type of impotence develops from ‘performance anxiety’ – a man’s fear that he won’t perform well during sexual intercourse. Stress caused by problems on the job, marital problems or financial difficulties can also lead to this type of impotence
Psychological causes of impotence include:
- Stress and anxiety at work or at home
- Worry about poor sexual performance
- Marital discord
- Unresolved sexual orientation
Other causes are due to defective blood flow or nerve function to the penis.
For many years, it was believed that 90% of impotent men had a psychological cause for their problem. However, as a result of recent medical research, it is now known that at least half of the men suffering from impotence can actually trace its origin to a physical problem.
If your erections do not become firm enough to allow for vaginal penetration, you have impotence. If your erections have the necessary rigidity, but are only firm for a brief period, you may have the problem. If your erection loses its strength upon penetration, you probably have the problem.
If any of these scenarios fit you, it may be time to admit it, and begin to move towards a treatment that can change your life.
Many men experience short episodes of impotence. Temporary impotence can be caused by stress or by drinking too much alcohol. But overall, one in ten men are continually unable to have an erection firm enough for successful sexual intercourse.
Erectile dysfunction can occur in men at any age. According to studies by the National Institute of Health, 5% of men at the age of 40, and approximately 15%-25% of men at the age of 65 or older, have some degree of erectile dysfunction. Erectile dysfunction affects all races and crosses all ethnic and economic boundaries.
Impotence can also be caused due to diabetes. Of all the conditions male diabetics face, impotence is the most personal. But it is also very common. The overall incidence of impotence in men with diabetes is two to five times higher than it is in the general male population. This does not mean that impotence is inevitable or permanent.
The procedures & tests to detect impotence include
- Nature of the Impotence: The first step in the diagnosis is to determine whether the impotence is physical or psychological. The physician may start by asking as to how the impotence developed
- General Examination & Tests: After asking questions about the impotence, the physician will then conduct a thorough general examination. The physician usually conduct tests to find out the cause of the impotence
- Other Tests: can determine if the blood flow to the penis is impaired. Still others will reveal as to whether hormone problems are causing the impotence
For Male Infertility
(Sperm Function Study is an accurate way to predict fertility potential)
Treatment For Impotence
Impotence, whether it is due to diabetes or some other cause, does not have to be permanent. Virtually every patient with impotence can be helped. And, in many cases, couples may choose between several effective treatment options.
For most men, the cause of impotence can now be identified fairly easily. Once identified, proper treatment can be recommended to help them return to a satisfactory sex life.
A lot of men become sexually impotent, but never admit it to themselves. Sadly, this denial prevents them from enjoying sexual activity on a regular basis. A man who behaves in this way has a lot of company. Up to one in ten men are impotent, but only 5% of them have ever been treated for it.
Ignoring the problem of impotence was normal behaviour years ago but sexual well-being is now moving to the forefront as a key indicator of total health. As more men are living longer, they have an interest in treating impotence. The pride factor is no longer the barrier to treatment that it once was. Today, there are many effective treatments to choose from, both surgical and non-surgical. But the first step is to admit the existence of the problem.
Whether the cause of impotence is due to diabetes or to other causes, the problem can be overcome. As our understanding of impotence has increased, several new treatment options have been developed.
If you have impotence, please ask your physician for recommendations concerning the steps to be taken to have your problem evaluated and treated.
Depending upon the cause of impotence, the physician may recommend counselling or therapy, hormone injections, a change in prescription medications, self-injection of medication to cause erections, an external vacuum device or, occasionally, oral medication.
You should also discuss the option of surgical treatment. The most common surgical procedure to treat impotence is a penile prosthesis implantation. For a few select candidates, a surgery to correct a blocked artery or a leak in the pelvic veins may also be an option.
In many cases, several of these treatments for impotence may be appropriate to restore sexual potency. The patient may then choose the treatment method with which he feels most comfortable.
It is also very important to involve your sexual partner in this decision-making process. Couples who participate together in planning the treatment are almost always happy with the results. The following measures can be taken to remedy erectile dysfunction:
- Changing Habits and Medications
- Quitting Smoking and Changing Prescription Medications : may help address the condition.
- Hormonal Medications : Only 5% of erectile dysfunction cases are caused by irregular levels of sex hormones, such as low levels of testosterone or excess estrogen. There are medications that restore this balance. Only 5% of erectile dysfunction cases are caused by irregular levels of sex hormones, such as low levels of testosterone or excess estrogen. There are medications that restore this balance.
- Professional Counselling : Because impotence can often result from a combination of psychological and physical factors, counselling can reduce anxiety. This therapy is often used in combination with other treatments as directed by a physician.
- Oral Medication: Yohimbine occurs naturally in the bark of evergreen trees and has been used as an aphrodisiac for centuries by Indians and Africans. It is believed that the drug works by enhancing nerve sensitivity in the penis. While there have been no large-scale studies to prove the drug’s effectiveness, a small percentage of men report it to be helpful for erectile dysfunction.
Recently, a new drug, sildenafil citrate (Viagra), has been introduced, which acts to increase nitric oxide levels and other primary mediators of erection. Studies suggest that the drug is effective in selected groups of patients. However, the drug has to be used under medical supervision as it has been found to have known interactions with other drugs and should be used with caution in hypertensives.
- Vacuum Therapy: This treatment enables an erection by increasing blood flow to the penis through negative pressure suction generated by the device used for this, treatment. In this way, the patient can obtain penile enlargement and rigidity for sexual intercourse.
- Injection Therapy: One of the newest forms of treatment involves the self-injection of a certain medication into the side of the penis. This relatively painless injection produces erections of good quality in about 70-80% of patients.
- Surgical Treatment: This treatment is usually reserved for those patients whose blood flow has been blocked by an injury to the penis or pelvic area. For these select candidates, a surgery to correct a blocked artery or a leak in the pelvic veins is an option. The goal of this treatment is to correct the blockage of blood flow to the penis so that erections will occur naturally.
- Penile Prostheses: The most common surgical procedure to treat impotence is that of penile prosthesis implantation. This treatment involves the surgical placement of a device into the two sides of the penis, allowing erections as often as desired. These implants come in two forms – an inflatable device and semi-rigid rods. This treatment is recommended only after discussing with the patient all other available options. A prosthesis is a long-term solution, which is offered after careful consideration and discussion with the patient.
The good news for many men and their partners is that erectile dysfunction can usually be treated safely and effectively. In the light of recent medical advances, men no longer need to suffer from erectile dysfunction in silence. Their impotency no longer needs to remain as a disruptive factor in their relationships. Most importantly, couples can now fully enjoy the enriching and exhilarating joy of intimate sexual contact.
Couples need to communicate openly and honestly with each other. Most importantly, couples need to confront any concerns they may have about erectile dysfunction by discussing their feelings and reassuring each other that they still care. Couples need to maintain this communication throughout the treatment process.