Chapter 4: Facts about Erectile Dysfunction
Additional Treatments
Medications like Viagra and Cialis and herbal remedies like Yohimbe can treat erectile dysfunction if the problem is physical. Sometimes ED is caused by something mental. If this is the case; you aren’t going to want to take something with such an intense physical effect as Viagra.
If the cause of your ED is mental or you have prostate cancer; there is a combination of penile injections that have been known to be effective on ED. The injections consist of the drugs papaverine hydrochloride, alprostadil and phentolamine mesylate. The amount of each drug in the combination varies from doctor to doctor. The combination of the three drugs is injected directly into the shaft of the penis to promote an erection.
Various penile injections, penis implants and vacuum pumps have been used in the treatment of ED over the years. There are also some surgeries that have proven to be very effective even in the most severe cases of ED. If you have a condition where your veins constrict or are affected by disease; there is a rare surgery that involves redirecting the blood flow into the penis completely if the standard veins are too small.
Penile Injections:
One ED treatment that is not as common as it used to be is penile injections. This involves injecting a drug directly into the penis to promote an erection. One such drug is called alprostadil. This drug acts as a muscle relaxer to loosen the muscles around the shaft of the penis. You have to inject the drug yourself just before you have sex. Papaverine is also used in penile injection therapy. Both of these drugs have been known to cause a prolonged erection (priapism) or pain when the penis is fully engorged. If the penis does not go down when it is supposed to; you have to get another injection of epinephrine to force it down.
Alprostadil can also be inserted into the penis through the urethra. You insert a tube into the urethra with a small pump on the end of it. When the tube is all the way in; you press down on the pump and it pushes a pellet containing the drug into the penis. It takes about 10 minutes for the drug to take effect and the erection generally lasts around an hour or so. The obvious side effect is pain in the urethra and a burning sensation. Both the injection and the burning can cause a lot of pain and discomfort.
Vacuum Pumps:
One of the traditional ED treatments that are still used often today is the vacuum penis pump. This involves inserting your penis into a plastic tube with a pump on the end of it. The pump is used to pull all the air out of the tube. As the vacuum pulls the air out; it starts pulling blood into the penis as well. The corpora cavernosa tissue in the shaft is filled with blood so an erection can be achieved. In order to hold the blood inside the penis; a cock ring is placed over the base of the penis applying pressure to the shaft. You must be careful not to leave the pump on too long or it could cause soreness and bruising.
Penile Implants:
Various penile implants are used to treat ED when all other treatments have been exhausted. These are painful surgical procedures that are performed when there is absolutely no blood flowing into the penis. A standard penile implant consists of two silicone rods that are bendable. They are surgically implanted into the shaft of the penis. You can bend them up for intercourse and bend them back down afterwards. These implants are often successful in allowing a man with ED to have intercourse, but they can be uncomfortable. The penis is not allowed to move around as much as it normally would and could cause an embarrassing bulge.
Inflatable Penile Implants:
Inflatable penile implants are surgically inserted much the same way a standard implant is, but more parts are involved. Two hollow rods are implanted into the penis shaft. Tubes run from the rods to a reservoir that is placed in the abdomen and a pump that is placed in the scrotum. When the pump is squeezed; fluid is pulled out of the reservoir and pumped into the hollow rods in the shaft of the penis and the penis becomes erect. To get the penis to go back down you just repeat the procedure and the pump will pull the fluid back out of the shaft and into the reservoir. This type of implant is not as successful as a standard penile implant and has been known to cause infections or simply not work. Once you have the surgery; you can start having sex after a couple months of recovery. CAUTION: Once you have had this surgery; your ED will be permanent. You will never be able to achieve an erection again without the aid of the implant.