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The following article was published in our article directory on July 26, 2010.
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Vacuum Pumps, Penile Implants and Pills: A Review of Treatments for Impotence

Article Category: Advice

Author Name: Bob Smelyansky

Impotence may not be a potentially grave condition that can threaten your life, but its manifestations are so cumbersome that it is a matter that needs attention because it could destroy relationships, cause couple dissatisfaction and drive males to depression and anxiety.

Impotence is strictly defined as the failure to attain or maintain an erection that can complete a satisfactory sexual activity in more than 25% of attempts. The hallmark of impotence is the inability to have a successful erection, with or without any associated problems with ejaculation or orgasm. Erectile dysfunction is present in some degree in 50% of males aged 40 to 70 years old.

To understand impotence, one must have a basic knowledge on how penile erection occurs.

Penile erection happens when blood flow to the penis increases and fills up the organ's erectile tissues---- the corpora cavernosa and spongiosum. The increase in blood flow that fills up the penis during erection is due to the relaxation of the penile arteries after sensory or psychological stimulation that signals the limbic system, the central control of sexual pleasure and stimulation. The limbic system consequently sends nervous signals to the autonomics to initiate an erection. Potent substances such as nitric oxide and vasoactive substances released from blood vessels enhance arterial dilatation and smooth muscle relaxation of the penile tissues. All these processes contribute to the distention, engorgement and firmness of the penis that form an erection.

Impotence can be divided into psychogenic or organic etiologies. The most common form of impotence is a mixed-etiology of psychological and organic reasons. Certain diseases are associated with impotence which includes diabetes, hypertension, smoking, depression and cholesterol.

Here is an overview of the surgical and non-surgical treatment options for impotence that men can choose from with the proper advice from a urologist or surgeon.

- Transurethral therapy- this is the method where Alprostadil, a drug that is potent in relaxing penile arteries and the erectile tissues, is given through the urethra and rapidly absorbed in the corpus cavernosum and spongiosum of the penis. This is popularly known as the MUSE® , which consists of a small pellet administered in the distal urethra through a plunger device. Penile pain is the pervasive side-effect of this procedure that makes it relatively unpopular.

- Penile implants – these devices are surgically placed in the penile tissues that act as internal penile pumps. The use of penile implants has been successful among men who have a physical cause of impotence such as diabetes and prostate surgery with a success rate of 90%. Clinical studies have shown though that having penile implants works more as a confidence booster since men have reported no radical improvement in the quality of sexual performance or orgasm, only an enhanced desire and libido. The down side of this method is that it permanently destroys penile tissues and causes damage that can cause infection and penile deformity.

- Vacuum pumps – these are mechanical devices that draw blood into the penis through a cylindrical device that is placed around the organ. The effect is temporary penile enlargement and engorgement but is preferred by most men because it is non-invasive and no drugs need to be taken. The danger of these vacuum pumps is in the damage it causes on the penile tissues and blood vessels when excessive pumping force is applied.

- Drug therapies with Viagra or Cialis – the introduction of these drugs have given men with impotence a new hope without having to deal with the pain and expenses of surgery. Sildenafil (Viagra) and Cialas (Tadalafil) belong to the same class of drugs and act in a similar way. Both are Phosphodiesterase inhibitors which act on the enzyme that stops erection thus increasing blood flow to the penile tissues and prolonging erection. Clinical trials have proven these drugs to be effective with the proper precaution such as avoiding intake with drugs such as nitrates.

Treatment of erectile dysfunction was once limited to surgery only that involves penile prosthesis. With the introduction of drugs such as Viagra and Cialis, males have opted for the medical treatment over other treatment options that involved injections and vacuum pumps. Other non-specific treatments of male impotence include lifestyle changes such as cessation of smoking and alcohol; psychosexual therapy is also advised for impotence with a psychogenic etiology. The choice of treatment for impotence is a decision you should make with your partner and with proper advice from a doctor.

Keywords: diabetes, erectile dysfunction, impotence, viagra, cialis, premature ejaculation, prostate, balding, smoking

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