Erectile dysfunction - Management

Management options: 

  • Psychogenic impotence
  • Impotence of organic or mixed aetiology
    • treat specific conditions
    • Oral anti - impotence drugs
    • Self injection therapy
    • Vacuum constriction devices
      • particularly suitable for those who have a partial erection
      • requires a certain amount of manual dexterity or an understanding partner
      • contraindicated in those with Peyronie's disease, bleeding disorders / on anticoagulants
    • Penile implants
      • for those not responding to above treatments or those with Peyronie's
      • satisfaction > 95%
      • infection risk 1-2%
      • usually in hospital for 2 - 4 days after an inflatable prosthetic implant; shorter with malleable implant
      • feel comfortable within 2 - 6 weeks
      • sexually active after 6 - 12 weeks
      • no loss of penile sensation
      • if able to ejaculate before, they will not lose this ability
    • Vascular surgery
      • for young patients with localised vascular disease eg those with pelvic trauma following an accident
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