CONDITIONS
Erectile Dysfunction and Premature Ejaculation
Erectile dysfunction:
Erectile dysfunction, also referred to impotence, occurs when men are unable to get or keep an erection firm enough to have satisfactory sexual intercourse.
Up to 40% of men at age 40 have some degree of erectile dysfunction. It has recently been described as the Urologic “Canary in a coalmine”. Erectile dysfunction is often a signal that there may be underlying cardiovascular disease that needs urgent evaluation.
Erectile dysfunction may be due to:
- Abnormal/deficient blood supply to the penis
- Abnormal/deficient nerve supply to the penis
- Abnormal genital anatomy
- Hormonal abnormalities
- Psychological causes
First-line therapy is usually with so-called PDE-5 inhibitors like Sildenafil (Viagra), Tadalafil (Cialis), Vardenafil (Levitra). Failure to respond to these drugs may indicate a need to progress to injection therapies and/or vacuum constriction devices. Surgery is also offered in the form of placement of penile prostheses as a more durable/permanent solution.
Premature ejaculation:
Premature ejaculation is the most common form of sexual dysfunction in men younger than 40. It manifests as ejaculation earlier than desired with a perceived lack of control over ejaculation leading to distress and sexual dissatisfaction.
Premature ejaculation is treated with medication such as PDE-5 inhibitors, topical anaesthetic creams and certain anti-depressants. Certain behavioural techniques may also be effective in increasing the time from arousal and penetration to orgasm and ejaculation.