Most men experience erectile dysfunction at some time, usually a result of fatigue, temporary stress, or excessive alcohol consumption. These temporary occurrences of impotence are not to be worried about. If, however, the condition continues or interferes with your normal sexual activity, you should consider seeing a urologist - a doctor knowledgeable about impotence and its treatments. For most, patients, the contributing factors towards impotence can now be identified, offering most men -regardless of age - successful treatment options. At the Abington Urological Specialists, we focus on resolution of a problem which not only affects men, but their partners as well.

WHAT CAUSES ERECTILE DYSFUNCTION?

A natural erection is the result of numerous complex processes. In 75 percent of cases, erectile dysfunction is the result of more than one factor.

Physical Factors

• Vascular (Blood Vessel) Disease: These include Arteriosclerosis, Diabetes, and abnormal venous drainage.
• Neurologic Disorders: These may result from brain or spinal cord injury.
• Diabetes: Can effect both blood flow and nerve signals.
• Previous Treatments: Radiation may be a cause of erectile dysfunction.
• Chemical Imbalances: The erectile reflex may be affected when testosterone, the primary male hormone, is at a low level.
• Medications and Drugs: Medications used in the treatment of high blood pressure and heart disease may produce impotence as a side effect. Alcohol, a central nervous system depressant, and the nicotine in cigarettes, a blood vessel constrictor, may also produce impotence.

• In some cases, a psychological factor such as fear, depression, stress, anger or marital problems may cause impotence. For some men, "performance anxiety" may be the source of the problem.

In a process as complex as penile erection, problems can occur for many reasons. An erectile problem will often have more than one cause, physical or psychological, or both. Distinguishing between the causes is necessary before treatment can begin. We utilize a number of approaches that will help you achieve the level of intimacy you desire.

• Careful medical and sexual history
• Comprehensive physical examination
• Appropriate non-invasive diagnostic testing. These may include hormonal studies, blood flow evaluation or sleep monitoring (Rigiscan or nocturnal penile tumescence).

Treatment varies based on the cause of the problem. Today, an overwhelming percentage of individuals are able to achieve success through non-surgical means. These choices are individualized to meet the needs of the, couple.

Non-Surgical Options

• Pharmacologic Treatment: Our increased understanding of the complex process of erectile functioning is enabling rapid growth of new medical therapies.
  • Oral Therapy: The introduction of Viagra in 1998 certainly has changed the management of erectile dysfunction. Unless contraindicated, Viagra is now used as first-line therapy for erectile dysfunction. Viagra is contraindicated in those patients taking any form of nitroglycerin (nitrates) or those patients with significant cardiac dysfunction. Since our goal at Abington Urological Specialists is the highest quality of patient care, a careful history is obtained from each patient to determine whether or not Viagra is indicated. Even if Viagra can not be prescribed, several other options for the management of erectile dysfunction exist. By late 1999, there may be other oral medications available for treatment of erectile dysfunction. As newer oral therapies become available, Abington Urological Specialists will offer these treatments to those patients who do not respond to other therapies.
  • Urethral Suppository: A pellet of alprostadil is inserted into the urethra to facilitate erections. Dose adjustment is necessary.
  • Penile Injection Therapy: Vasoactive agents are used for self injection into the penile shaft. Usually, a patients is initially given a trial of alprostadil (Caverject or Edex) but may also be offered combinations of medications (trimix) in select cases.

• Vacuum Erection Devices: A vacuum cylinder is used to generate an erection by bringing blood flow into the penis.

• A penile prosthesis (implant) is a device surgically placed within the penis to allow a man to have an erection. Innovations and technologic advances have improved the reliability and cosmetics of these devices and we offer all types, from the simplest to the most complex 3-piece inflatable penile prostheses.