Erectile Dysfunction
Erectile Dysfunction Treatment
Erectile dysfunction (ED) is a condition that can impact confidence, relationships, and emotional well-being. ED means struggling to achieve or keep an erection firm enough for sexual intercourse, and it’s a common experience, especially with men above the age of 40. However, younger men can also face ED, and it’s nothing to be ashamed of—it’s often part of a bigger health picture.
There are many causes of ED, often involving a mix of physical and emotional factors. Health issues like diabetes, high blood pressure, obesity, and heart disease can play a significant role, as can emotional factors such as stress, anxiety, or depression. Lifestyle choices, such as smoking or excessive alcohol consumption, can also impact ED.
The good news is that ED treatment options are available to address these causes and help you regain confidence. Treatments range from lifestyle changes and counseling to medications and advanced therapies available at several ED treatment clinics location in the UK. For more personalized approaches, many private ED treatment London clinics offer ED treatment online consultations to get you started on a treatment path that’s convenient and discreet.
When to See a Urologist
- Persistent difficulty achieving or maintaining an erection
- ED affecting your confidence or relationships
- Decrease in sexual desire (libido) with erection issues
- Symptoms persisting for over three months
- Presence of conditions like diabetes or cardiovascular disease that may contribute to ED
If these symptoms sound familiar, it may be time to seek professional help at an ED treatment UK clinic.
How Dr. Giulio Garaffa Can Help
Dr. Giulio Garaffa is a highly experienced ED treatment doctor and a leading expert in erectile dysfunction treatment in London. He provides compassionate, personalized care to help address the physical and emotional sides of ED. Offering some of the best ED treatment options in the UK, Dr. Garaffa tailors each approach to meet your unique needs, restoring your confidence and quality of life.
What is Erectile Dysfunction?
Erectile dysfunction, also known as impotence, can be defined as the inability to achieve and/or maintain the rigidity necessary to complete successful sexual intercourse.
Erectile dysfunction is a widespread problem that affects millions of men in all age groups.
Impotence is not only a problem for the patient; it can strain the couple and the family as well. It can ultimately lead to embarrassment and frustration and can be responsible for a patient's low self-esteem. There is a strong association between erectile dysfunction, Peyronie's Disease, and cardiovascular risk factors and impotence may represent the first sign of cardiovascular disease.
As erectile dysfunction can be the first warning sign of diffuse cardiovascular disease and a prompt intervention can treat erectile dysfunction and stop the progression of cardiovascular disease, the patient needs to seek medical attention.
A consultation with a Urologist who is experienced in the evaluation and treatment of erectile dysfunction represents, therefore, the best solution for the patient.
How Does a Normal Erection Occur?
An erection is an involuntary reaction in response to sexual stimulation or erotic fantasy. Both sexual stimulation and erotic fantasy cause a chain reaction in which the brain, nerves, heart, blood vessels, and hormones work together to produce a rapid increase in the amount of blood flowing into the penis. The blood remains trapped inside the tunica albuginea of the penis and progressively engorges and distends the two spongy chambers in the shaft of the penis. As the two chambers rapidly fill with blood, they expand, and the penis becomes firm and elongated.
What Are the Causes of Erectile Dysfunction?
Erectile dysfunction can be subdivided into psychogenic and organic. Pure psychogenic erectile dysfunction cannot trace its origin to a physical problem or disease and is more common in younger men.
However, organic erectile dysfunction is much more common than pure psychogenic erectile dysfunction, and in most cases, the causes can be easily identified. Once identified, proper treatment can be recommended to help patients return to a satisfying sexual life.
There is a significant number of men who suffer from a combination of psychogenic and organic erectile dysfunction.
Organic erectile dysfunction is usually caused by an injury (to the brain, spinal cord, peripheral nerves, or arteries), by a disease (diabetes, high blood pressure, or high cholesterol), by an operation (prostate gland removal, urinary bladder removal, surgery to the rectum), and by substance abuse (tobacco, drugs, alcohol, and some medications).
What Else is Essential to Know About Erectile Dysfunction?
Which Investigations Are Necessary in the Patient with Erectile Dysfunction?
A thorough examination and history taking is necessary to distinguish between psychogenic and organic erectile dysfunction. Patients with psychogenic erectile dysfunction should be further investigated with a nocturnal penile tumescence test to confirm that the nocturnal erections are preserved. The confirmation of the presence of normal nocturnal erections rules out the presence of an organic cause of erectile dysfunction, and the patients should be therefore reassured.
When organic erectile dysfunction is suspected, and the underlying cause is not obvious from the examination and history, efforts should be made towards the identification of the underlying condition since erectile dysfunction may represent the first sign of diffuse cardiovascular disease. Prompt identification of possible cardiovascular risk factors such as diabetes, high blood pressure, and high cholesterol levels is paramount to set up an adequate treatment plan and prevent further progression of the cardiovascular disease.
The Doppler Ultrasound scan of the penis is a relatively simple investigation, but it provides very important information on the blood supply to the penis.
What are the Options for Erectile Dysfunction Treatment?
The management of the patient with erectile dysfunction is tailored to the underlying cause of erectile dysfunction and to patients’ preferences.
Various drugs are now available for the treatment of erectile dysfunction. Some medications are administered orally; some are injected directly into the penis, whilst others are inserted into the urethra at the tip of the penis. When medical treatment is ineffective and contraindicated, the vacuum constriction device or penile prosthesis implantation guarantees the rigidity necessary for sexual intercourse.
Which Oral Medications Are Available in Patients with Erectile Dysfunction?
The most common oral medications prescribed in patients with erectile dysfunction are Sildenafil, Tadalafil, Vardenafil, and Avanafil. All these medications help to enhance erections and, therefore, do not trigger automatic erections as injections instead do. Therefore, sexual stimulation is necessary for these medications to work.
The most common side effects of these medications are headache, facial blushing, upset stomach, and mild temporal visual effects (only for Sildenafil). In most cases, the side effects are minor and tend to reduce with time. Therefore, only very few patients decide to discontinue the treatment due to side effects. The most common side effects of these medications are headache, facial blushing, upset stomach and mild temporal visual effects (only for Sildenafil). In most cases the side effects are minor and tend to reduce with time. Therefore, only very few patients decide to discontinue the treatment due to side effects.
The most common side effects of these medications are headache, facial blushing, upset stomach, and mild temporal visual effects (only for Sildenafil). In most cases, the side effects are minor and tend to reduce with time. Therefore, only very few patients decide to discontinue the treatment due to side effects. The most common side effects of these medications are headache, facial blushing, upset stomach and mild temporal visual effects (only for Sildenafil). In most cases the side effects are minor and tend to reduce with time. Therefore, only very few patients decide to discontinue the treatment due to side effects.
Who is the Best Candidate for Injections and Intraurethral Medications?
Injections are indicated in these patients who do not respond to oral medications or when oral medications are contraindicated.
Injection therapy induces an erection even without the need for sexual stimulation. The main advantage of injections is that they can be easily self-administered, whilst the main risk is to induce a prolonged erection and may occur if an excessive dose of the medication has been injected.
The main reasons why patients quit injections are inadequate response, fear of needles, desire for a permanent treatment alternative, and concerns over side effects.
Injection therapy induces an erection even without the need for sexual stimulation. The main advantage of injections is that they can be easily self-administered, whilst the main risk is to induce a prolonged erection and may occur if an excessive dose of the medication has been injected.
The main reasons why patients quit injections are inadequate response, fear of needles, desire for a permanent treatment alternative, and concerns over side effects.
Who is a Good Candidate for the Vacuum Pump?
he vacuum pump is a tube which is sealed around the flaccid penis. With the creation of a negative pressure, blood is rushed into the chambers of the penis. Once the desired rigidity is achieved, a constricting ring is applied to the base of the penis to prevent the blood from rushing out of the penis, and the vacuum pump is then removed. The vacuum pump can be a viable solution for patients who do not respond or are not suitable for oral and injectable medications and are not keen on penile prosthesis implantation.
What is Rehabilitation of the Corpora Cavernosa?
Some patients will experience a temporary loss of their erections following surgery or trauma, which has compromised the nerves and vessels feeding the penis. The lack of spontaneous erections induces progressive damage to the corpora of the penis with the deposition of scar tissue as no fresh blood is rushed into the chambers of the penis on a regular basis. Scar tissue formation is an irreversible process that produces penile shortening and weak erections.
Therefore, while the vessels and nerves feeding the penis regenerate, it is paramount to trigger erections on a regular basis in these patients in order to bring fresh blood full of nourishment into the chambers of the penis and therefore minimize the formation of scar tissue.
How is Rehabilitation of the Corpora Cavernosa Performed?
Rehabilitation of the penis can be performed with oral medication, injections, or the use of the vacuum pump. Rehabilitation can be usually started with oral medications, while injections and the vacuum pump are indicated in patients who have not responded to oral medications.
How Long Should Rehabilitation Continue?
Rehabilitation should continue until natural erections have been fully restored. If there is no recovery of natural erections, a long-term solution such as oral medications, injections, vacuum pump, or penile prosthesis implantation should be considered.
What is Low Intensity Shockwave Therapy?
Extracorporeal shockwave treatment (ESWT) can be offered to selected patients suffering from erectile dysfunction to regenerate the tissue inside the corpora of the penis to improve the quality of the erections.
The waves, which are produced by a handpiece that is placed on the body, can be transmitted to the corpora of the penis without involving nearby tissues.
Although the biological mechanism of action is not yet well understood, it has been suggested that ESWT promotes the release of angiogenic factors, which can help to generate new blood vessels, thus improving the blood supply to the corpora of the penis and, ultimately, the quality of the erections.
The waves, which are produced by a handpiece that is placed on the body, can be transmitted to the corpora of the penis without involving nearby tissues.
Although the biological mechanism of action is not yet well understood, it has been suggested that ESWT promotes the release of angiogenic factors, which can help to generate new blood vessels, thus improving the blood supply to the corpora of the penis and, ultimately, the quality of the erections.
Erectile Dysfunction Treatment in London
Dr. Giulio Garaffa is a highly experienced ED treatment doctor in London. He provides advanced treatment options according to patients’ personal preferences, keeping in mind their tolerance for side effects. Dr. Garaffa is devoted to restoring your confidence and quality of life.