International Pain Institute

Erectile Dysfunction or Impotence is the repeated inability to get or keep an erection firm enough for vaginal penetration or sexual intercourse. The word "impotence" may also be used to describe other problems that interfere with sexual intercourse and reproduction, such as lack of sexual desire and problems with ejaculation or orgasm.

Erectile Dysfunction, or ED, can be a total inability to achieve erection, or an inconsistent ability to do so, or a tendency to sustain only brief erections. In older men, ED usually has a physical cause, such as disease, injury, or side effects of drugs. Any disorder that causes injury to the nerves or impairs blood flow in the penis has the potential to cause ED. Incidence increases with age: About 5 percent of 40 - year - old men and between 15 and 25 percent of 65 - year - old men experience ED.

Damage to nerves, arteries, smooth muscles, and fibrous tissues, often as a result of disease, is the most common cause of ED. Diseases - such as diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurologic disease - account for about 70 percent of ED cases. Between 35 and 50 percent of men with diabetes experience ED.  

Heart disease and vascular problems also raise the risk of erectile dysfunction. Smoking, being overweight and avoiding exercise are possible causes of ED.

Also, surgery (especially radical prostate and bladder surgery for cancer) can injure nerves and arteries near the penis, causing ED. Injury to the penis, spinal cord, prostate, bladder, and pelvis can lead to ED by harming nerves, smooth muscles, arteries, and fibrous tissues of the corpora cavernosa.

In addition, many common medicines - blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine (an ulcer drug) - can produce ED as a side effect.

Experts believe that psychological factors such as stress, anxiety, guilt, depression, low self - esteem, and fear of sexual failure cause 10 to 20 percent of ED cases. Men with a physical cause for ED frequently experience the same sort of psychological reactions (stress, anxiety, guilt, and depression). Other possible causes are smoking, which affects blood flow in veins and arteries, and hormonal abnormalities, such as not enough testosterone.

ED is treatable at any age. More men have been seeking help and returning to normal sexual activity because of improved, successful treatments for ED. The most publicized advance was the introduction of the oral drug sildenafil citrate (Viagra) in March 1998. Most physicians suggest that treatments proceed from least to most invasive. For some men, making a few healthy lifestyle changes may solve the problem. Quitting smoking, losing excess weight, and increasing physical activity may help some men regain sexual function.

Cutting back on any drugs with harmful side effects is considered next. For example, drugs for high blood pressure work in different ways. If you think a particular drug is causing problems with erection, tell your doctor and ask whether you can try a different class of blood pressure medicine.

Psychotherapy and behavior modifications in selected patients are considered next if indicated, followed by oral or locally injected drugs, vacuum devices, and surgically implanted devices. In rare cases, surgery involving veins or arteries may be considered.

Erectile Dysfunction (Impotence) Treatment

Recently, the new way of ED treatment has been introduced. The small electronic device with the size of cardiac pacemaker sending electrical impulses to the special nerves is regulating en erection process and dramatically improving erection. This device is capable to maintain the level of erection firm enough for vaginal penetration and sexual intercourse. This electronic device is implanted inside the body and it is programmable and controllable from outside the body. Pressing the button generates the electronic signal, which stimulates erection in male and orgasmic sensation in female.

The electrical conductor (electrodes) is positioned in the epidural space and stimulates the nerves causes dilatation of the penile and clitoris arteries, which results in an erection and pre orgasmic sensation. In female, the stimulation of the sacral part of the spinal cord increases sexual desire and escalation to the level of orgasm.

This procedure performing on outpatient basis under local anesthesia and patient goes home in the same day. The pain is minimal, the recovery is fast and easy and the level of success is very high.