Erectile dysfunction, also known as impotence, represents the inability to achieve and/or maintain the penile rigidity necessary to successfully complete sexual intercourse. This embarrassing issue can strike men of all ages, yet can almost always be resolved.
It's a problem affecting millions of men across a variety of age groups – the NHS estimates say as many as 40% of men aged 50 and more than 70% for those over 70.
It not only represents a problem for the man but can also cause strain to his partner and family, leading to frustration, low self-esteem and even depression. There is a strong association between erectile dysfunction, Peyronie's disease and cardiovascular risk factors so the problem could even represent the first sign of cardiovascular disease.
Therefore, prompt intervention will not only treat erectile dysfunction but also possibly halt the progression of cardiovascular disease, so it's important that men seek advice as soon as they notices a problem.
Erectile dysfunction can be diagnosed as either psychogenic (of psychological origin rather than a physical or disease) or organic. Psychogenic erectile dysfunction tends to manifest more often in younger men.
Organic erectile dysfunction is much more common and, in most cases, the cause can be identified. Causes vary, and can be due to an injury (to the brain, spinal cord, peripheral nerves or arteries), a disease (diabetes, high blood pressure or high cholesterol), an operation (prostate gland or urinary bladder removal, surgery to the rectum) or by substance abuse (tobacco, drugs, alcohol and some medications).
Approximately 50% of men between the ages of 40 and 70 will experience erectile dysfunction to some degree, according to the NHS.
Although prevalence of erectile dysfunction increases with age, it should not be seen as an inevitable consequence of ageing.
With adequate treatment, the problem can be successfully treated in virtually all patients.
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 to rule out the presence of an organic cause and treatment can pursue easily.
When organic erectile dysfunction is suspected, a 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 to prevent further progression of any cardiovascular disease.
Patients with erectile dysfunction will need a treatment plan tailored to the underlying cause of the problem and to their preferences.
Various drugs are now available for the treatment of erectile dysfunction. Some administered orally; whilst some can be injected directly into the penis, or inserted into the urethra at the tip of the penis.
When medical treatment is ineffective and something else is needed, the vacuum constriction device or a penile prosthesis implantation guarantee the rigidity necessary for sexual intercourse.
The Cadogan Clinic is proud to work alongside with Mr Giulio Garaffa as our Uro-Andrology Surgeon as he is one of the leading experts in the field of erectile dysfunction. Mr Garaffa trained in Italy and the UK before being appointed as a consultant uro-andrological surgeon and honorary senior lecturer in urology at the Institute of Urology, University College London Hospitals.