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Erectile Dysfunction

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Erectile Dysfunction Overview

What Is Erectile Dysfunction?

Erectile dysfunction is the inability to achieve or maintain an erection adequate for sexual intercourse. It refers only to the ability to have erections and does not affect normal sensation, sex drive, or the ability to have an orgasm.

Who Does Erectile Dysfunction Affect?

According to the American Foundation for Urologic Disease, erectile dysfunction affects an estimated 18 million men in the United States. Data suggests that only a small percentage of men actually seek and receive treatment, even though erecti le dysfunction can usually be treated successfully.

Causes of Erectile Dysfunction

The penis is a complex structure of muscle, blood vessels, and nerves.

When a man becomes aroused, nerves signal the smooth muscle of the penis to relax. This allows arteries to pump more blood into the chambers inside the muscle. As the penis lengthens, the veins stretch and shut themselves off, which traps blood inside the penis.

After ejaculation, the smooth muscle contracts, the veins loosen their hold so blood can leave the penis, and the erection fades away.

Most erectile dysfunction is caused by a physical condition that affects the nerves or blood vessels responsible for erections.

Causes include diabetes, vascular disease, multiple sclerosis, Parkinson’s disease, surgery or radiation therapy for prostate cancer, or the side effects of medication. Psychological causes include anxiety, depression, or stress.

Diagnosing Erectile Dysfunction

Physician interview

The physician typically interviews the patient about many physical and psychological factors. The patient must be as frank as possible for his physician to make a diagnosis. He should not interpret these questions as intrusive or too personal if he expects to obtain help. These questions are very relevant and important for determining the proper approach. Even when erectile dysfunction has a clear physical cause, relationships and psychological factors can also have an effect.

Medical and personal history

The physician will take a medical and personal history and may ask about:

  • Past and present medical problems
  • Medications or drugs being used
  • Any history of psychological problems, including stress, anxiety, or depression

Sexual history

In addition, the physician will ask about the patient’s sexual history, which may include:

  • The nature of the onset of the dysfunction
  • The frequency, quality, and duration of any erections, and whether they occur at night or in the morning
  • The specific circumstances when erectile dysfunction occurred
  • Details of technique
  • The patient’s motivation for and expectations of treatment
  • Whether problems exist in the current relationship

Interviewing the sexual partner

If appropriate, the physician might also interview the sexual partner. In fact, including the partner in the interview process may help the physician to better decipher underlying causes and in turn better recommend treatment choices.

Erectile Dysfunction Treatments and Surgery

Our urologists offer a variety of treatments for erectile dysfunction. Treatment is based on the underlying causes of the condition.

Non-Surgical Treatments for Erectile Dysfunction

Non-surgical options include the use of oral medications, urethral suppositories, penile injections, and vacuum devices.

Penile Implant Surgery to Treat Erectile Dysfunction

When erectile dysfunction does not respond to non-surgical treatment, penile implant surgery may be considered.

Treatment at the UPMC Department of Urology

To schedule an appointment, contact us at 412-692-4100.

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