Many men have problems with their erections, in fact 40% of over 40 year olds are troubled with erectile dysfunction. Erectile dysfunction, or ED, can present for many reasons. In most cases it is due to poor blood flow to the penis (vasculogenic) or nerve problems (neurogenic). Examples of some illnesses that cause ED include: high cholesterol, high blood pressure, heart disease, peripheral blood vessel disease, diabetes, MS and Parkinsons disease. Many men with erectile dysfunction have had problems with their health for some time, whilst others may have had treatment for illnesses such as cancer. It is not uncommon for men who have had surgery or radiotherapy for cancer in the pelvis, to have erectile dysfunction. Types of treatments that cause ED include: Radical Prostatectomy, brachytherapy or external beam radiotherapy for Prostate Cancer, bowel removal or radiotherapy for rectal or anal cancer, Cystectomy (removal of the bladder ) or radiotherapy to the bladder for bladder cancer, and spinal surgery or radiotherapy for spinal cancers.
Erectile dysfunction can be treated in many ways, for example using medicines such as sildenafil (viagra) or vardenafil, injection therapy, intraurethral therapy, topical therapy and vacuum pump therapy. In some cases ED1000 shock wave therapy may be used. It is not uncommon for men to try two or three of these treatments before settling for one that works well for them and fits their lifestyle. For those where no treatment is effective the only option remaining is to consider penile implant surgery. This is usually in the form of a malleable or inflatable penile prosthesis.
Having a penile prosthesis means undergoing surgery. If a malleable prothesis is considered, this usually takes 1-2 hours, with a 24 hour hospital stay. For men having an inflatable prosthesis, surgery is more extensive and can take up to 3 hours, although hospital stay is usually 24 hours. The risks are important to recognise and include infection, pain, bleeding, bruising, wound problems, issues over cosmesis, buldging of the underwear, not having a truly natural erection, tilting of the end of the penis, changes in sensation, the malfunction or erosion of the prosthesis or its parts. The prosthesis can not be used immediately, it usually takes 6-8 weeks before the implant is ready to be used for sexual activity. In the majority of cases (90%) surgery and outcome is fine, whilst satisfaction rates are up to 80%. Implants are made by two main manufacturers: Coloplast and AMS.
We are able to undertake this type of surgery for men with erectile dysfunction. Undergoing this type of surgery should not be taken lightly and requires very close consultation and a good understanding of the operation that you are considering; we are able to help you make the right decision. We have experience in all valid types of treatments for ED and many men who come to ask our opinion on penile implant surgery usually proceed to use other forms of therapy before reconsidering penile implant surgery.
The world of medicine is in a state of constant flux. This is where we will provide you with a selection of interesting news about the medical world and our practice.
Prostate SelectMDx is now available at our clinics. Please call in advance if you wish to be considered for this test.
New therapies (Fortacin) for Premature Ejaculation now available at Urology Clinics (April 2019)
Shock wave therapy can assist in Peyronies disease & Prostatitis (April 2019).
Peyronies disease can now be treated with collagenase injections (XIAPEX) (Jan 2018).
Multi-parametric MR scanning of the prostate can help in diagnosing prostate cancer. Available at Spire Manchester and The Chrsitie Clinic.