Male Erectile Dysfunction: Impotence
Myron I. Murdock, M.D., F.A.C.S.
Male erectile dysfunction, (ED), or impotence is the inability for a sexually active male to obtain and sustain an erection for sexual purposes. This in the past has been a very embarrassing subject for many men and their partners, and, in fact, there has been very little diagnostic testing or treatments available up until 1973. This problem affects 30% of all adult males and 50% of all males over 40 years of age at some times. 85% of the causes for MED are physical and are organic and due to an actual physical problem, disease entity, or complication of another illness. In general, 40% of all 40-year-olds, 50% of all 50-year-olds, and 60% of all 60-year-olds have some form of ED, on occasion, although in general only 15% are of the severe form, that is to say inability to totally obtain any erections whatsoever.
Normal erection is the result of many factors working together. It requires good blood flow, normal nerves going to the penis, and good valve mechanisms in the blood vessels of the penis. The penis has two erectile bodies, the corpora caveronsae,
which are two long blood filled balloons, that become filled with high pressure blood, and become rigid, and the urethra, which conducts urine.
With the advent of an effective oral and safe medication Viagra (Sildenafil) the entire evaluation and treatments for male erectile dysfunction have become revolutionized. Other forms of therapy including self injection programs with vasoactive drugs, intraurethral placement of vasoactive drugs, external vacuum compression device, and implantation of inflatable penile prostheses are still available and have a place in the armamentarium of the urologist who deals in the problems of sexual dysfunction in men. With the advent of Viagra in March of 1998 the numbers of impotent patients seen by physicians have increased two-fold, and 50 to 75% of the patients will respond to Viagra. The remainder will need other treatment modalities, some of which include combinations of other modalities with Viagra. Any physician can prescribe Viagra, however the specialists who know the most about ED are urologists who specialize in the field of male sexual dysfunction. In those cases in which Viagra does not work, where the results are suboptimal, or in situations in which the cause for the impotence is not obvious, a patient should be seen by a urologic specialist.
Werner - Francis Urology Associates llc - Mid Atlantic Urology Associates llc
Greenbelt - Bowie - Laurel Maryland
(301) 441-8900 Fax (301) 982 0453
7500 Hanover Parkway Suite 206 Greenbelt, MD 20770