The problem of a rooster not crowing, a brother not getting hard, or not fully hard—how to treat it to get back to being fit as before. Certainly, these problems affect men’s confidence quite a bit.
Moreover, there is a chance that many couples may end their relationship. Wouldn’t it be better to restore sexual function without surgery? Patients with erectile dysfunction do not necessarily need treatment if the patient and spouse do not feel troubled by the inability to have sexual intercourse.
However, patients with this problem indicate that it may be caused by diabetes, high blood pressure, high blood lipids, as well as other risk factors. Therefore, even if they do not want to have sexual intercourse, they should get a health check-up.
Surgical Implantation of Penile Prosthesis
Erectile dysfunction, although not a disease, is a problem that undermines the mental state of those affected, including their families. Current treatments for male erectile dysfunction include various options such as taking supplements and taking Sildenafil group drugs to help penile erection.
Using Shockwave to stimulate blood vessels in the area. However, the methods mentioned have different limitations, such as Sildenafil cannot be used in heart patients taking nitrate drugs or may increase the risk of acute coronary syndrome in the general population.
Shockwave therapy may not help people with underlying diseases affecting sexual function, such as patients with paralysis, neurological diseases, or those with lower limb paralysis, etc.
Surgical Implantation of Penile Prosthesis (Penile Prosthesis or Penile Implants)
It is another safe and effective option that reduces the risk of drug use, provides more definite results, and can also solve problems in men with penile fibrosis, which causes a curved and painful penis during erection (Peyronie’s disease).
The penile prosthesis is a device with a mechanism surgically implanted inside the penis as a closed system, which cannot be seen from the outside. Its purpose is to make the penis strong enough to be inserted into the vagina during sexual intercourse normally.
The surgery does not affect the sensation of orgasm, ejaculation, urination, and does not increase the size of the penis. The results show that the initial satisfaction rate is over 90% for both men and their partners.
Types of Penile Prosthesis
Divided into 2 types as follows:
- Single-piece rigid type (nonhydraulic): This type of penile prosthesis does not have a complex mechanism, resulting in fewer mechanical failures. However, the downside is that it is unnatural, difficult to conceal, and cannot be expanded as desired.
- Three-piece type (hydraulic penile prosthesis): This type can pump fluid from a reservoir into the penile prosthesis when an erection is desired and can pump it out to soften when sexual intercourse is not desired. This allows good concealment and the ability to expand in size when erect. Some models can even increase the length of the penis when erect.
Who Can Have Penile Prosthesis Implantation?
- Those with erectile dysfunction who have tried many treatments without success.
- Those with other sexual problems including:
- Loss of sexual desire.
- Inability to ejaculate.
- Premature ejaculation.
- Those with penile fibrosis causing pain and curvature during erection (Peyronie’s disease).
What is Erectile Dysfunction?
Erectile dysfunction in men, commonly known as “erectile dysfunction,” is medically defined as the inability of the penis to become sufficiently erect, or to maintain an erection long enough during sexual intercourse, or the inability to complete sexual intercourse.
This condition, while not life-threatening, is a sign of overall physical health problems, especially diseases caused by abnormalities in the circulatory and vascular systems, such as stroke and ischemic heart disease, which all involve insufficient blood supply to the organ.
Additionally, erectile dysfunction may affect relationships with spouses and can lead to family problems.
At What Age Do Men Experience Erectile Dysfunction?
- Men under 40 years old – about 5% prevalence.
- Men over 40 years old – about 50% prevalence.
- By nature, penile erection is a neurovascular function controlled by hormones. Erection requires the normal function of four factors:
- Intact neuronal innervations.
- Intact arterial supply.
- Appropriately responsive corporal smooth muscle.
- Intact veno-occlusive mechanics. Normally, the penis is flaccid and responds to sexual stimulation.
Erectile Dysfunction is Divided into 3 Levels
Erectile dysfunction can be divided into 3 levels:
- Mild symptoms: able to successfully have sexual intercourse almost every time.
- Moderate symptoms: able to successfully have sexual intercourse about half the time.
- Severe symptoms: almost unable to successfully have sexual intercourse.
If erection occurs every time during intercourse, it is considered normal. The causes of erectile dysfunction are mostly a combination of physical diseases and psychological problems. The main cause is insufficient blood supply to the penis, requiring history taking, physical examination, and additional special tests.
Who is at Risk for Erectile Dysfunction?
- Age is a major and unavoidable risk factor. As age increases, the chance of ED also increases.
Society and economy: ED is more common in people with lower socioeconomic status. - Chronic diseases or underlying conditions.
- Cardiovascular disease: heart disease has the greatest impact, causing severe ED in about 13.2% of cases.
- High blood pressure: causes ED in about 62% compared to those without hypertension, and 8–10% of diagnosed hypertensive patients already have ED.
- Diabetes: causes ED in about 74.7% compared to non-diabetics.
- If all three diseases are present together, ED occurs in all cases.
- Previous surgeries such as pelvic surgery, urethral surgery, pelvic trauma, or spinal cord injury.
- Male hormone deficiency.
- Use of certain medications.
- Other behaviors such as smoking, alcohol consumption, exercise, and sexual behavior.
- Mental health, especially depression. Studies show that 50–90% of people with depression have ED.
Prevention of Erectile Dysfunction
Maintain good physical and mental health, get enough rest, exercise regularly, and avoid risk factors.
Treatment of Erectile Dysfunction
Both non-drug and drug or device-assisted treatments are available, with four main methods:
Phosphodiesterase type 5 inhibitors are the first choice for patients without contraindications (contraindicated in patients treated with nitrate drugs). Common side effects include headache, visual disturbances, flushing, and muscle aches.
- Injection therapy directly into the penis. This medication dilates blood vessels to bring blood into the penis, causing an erection lasting 30–60 minutes.
- Urethral suppository therapy using the same drug as injection but in a small pellet inserted into the urethra. After massaging the penis for about 5–10 minutes, the drug is absorbed and causes an erection.
- Vacuum erection device therapy involves placing a vacuum cylinder over the penis and pumping out air within 2–3 minutes, drawing blood into the tissue to cause an erection. Once fully erect, the vacuum cylinder is removed, and a constriction ring is placed at the base of the penis to maintain the erection.
- Shockwave therapy for erectile dysfunction.
Summary of Surgical Treatment for Erectile Dysfunction
Whatever the treatment method, the goal is to restore confidence in men and satisfaction in their relationships. Therefore, erectile dysfunction is not as worrying as it seems. The earlier it is detected, the better the chance of restoring near-natural function.
Erectile dysfunction is a natural issue, but if it interferes with life, shockwave therapy is a good option for men because it is easy, fast, effective, painless, safe, and has no side effects.
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