Oral Medication: Sildenafil (Viagra) is a new FDA approved medication that is taken approximately one hour before intercourse. Erection occurs after arousal.
VIAGRA - also known as SILDENAFIL - This is an FDA approved oral treatment for impotence with an approximate 60% success rate for organic impotence and about a 90% success rate for psychogenic impotence. Side effects occurring in less than 10% of patients, are: headache, flushing, stomach discomfort, nasal congestion; and at high doses, vision changes. It must be taken 1-2 hours before sex and arousal must occur before it will be effective.
2. Utheral Inserts
Urethral Insert: Prostaglandin E-1/Alprostadil (Muse) is a new FDA approved intraurethral insert that provides an erection.
The Muse is a tiny insert that fits into the urethral opening of the penis. The Muse contains the drug Prostaglandin E-1. The success rate is about 60-70%
3. Vaccuum Devices
Vacuum Erection Device: an external device that is used to get an erection.
A penile pump is a vacuum erection device that is manually operated by the patient. A pump creates a vacuum which in turn makes a penis hard. A special constricting ring is then placed at the base of the penis and this keeps it hard. These devices may be useful in men with impotence of almost any cause. This device has a success rate of 40 - 65%.
4. Penile Injections
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. Hormone Therapy
Hormone Therapy: topical patches or injectable treatment for a hormonal condition.
1. Penile Implants:
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.
PENILE IMPLANT SURGERY
This requires the placement of two implants in the penis; one in the left erectile chamber and one in the right. The implants and the pump which fills the implants are totally concealed inside the body and give excellent cosmetic and functional results in most patients.
The success rate is from 80 to 90% in terms of patient and partner acceptance, and almost 95% in terms of patient satisfaction. The implants are FDA approved.
There are two categories of implants: - the non-inflatable rods which are bendable and can be manipulated to give an erection, and inflatable implants which contain fluid to give a more natural erection. This fluid is transferred within or to cylinders in the penis to give hardness.
While less than 5% of patients choose this form of treatment initially, the final choice of treatment is a penile implant in 10% of patients. In U.S.A., approximately 20,000 implants are performed each year.
2. Penile Arterialization: Rerouting blood to the penis.
3. Venous Ligation: Tying off leaky veins.
Treatment for Psychogenic Dysfunction
Individuals and Couples
1.Marital and Family Therapy
2. Sex Therapy
5. Intraurethral Insert (Muse)
6. Prostaglandin E-1 (Caverject or Edex)
7. Sildenafil (Viagra)
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