Surgical Treatments for Erectile Dysfunction
©2006 Publications International, Ltd.
While surgical treatments can be
intimidating, they can also
be quite effective.
Urethral Inserts (MUSE)
An alternative to the injection is the urethral insert, which involves the insertion of a rice grain-size pellet of prostaglandin into the end of the penis. This is accomplished by using a plastic plunger specially designed for this purpose. The medication is absorbed through the urethra and produces an erection. Most men find this alternative delivery system acceptable. The results are adequate for about 30 to 40 percent of men, although the penis does not become rock hard. Fifteen percent of men complain of pain in the penis. MUSE treatment also requires a prescription. The medication costs $15 to $30 per pellet, but it is covered by many insurance plans.
Arterial and Venous Surgery
Arterial and venous surgery are used for two reasons: to reconstruct arteries to increase blood flow to the penis or to block off veins that let blood escape from the penis. Surgery should only be considered when a specific blood-flow problem is identified. Even then, results are not impressive, and few men are really good candidates for artery or vein surgery. To determine whether you are a candidate, further diagnostic tests will be necessary. When a patient has artery problems, all his arteries, blood vessels, and the spongy tissue of the penis are affected, so it's not just a matter of patching a few vessels. The best candidates for this type of surgery are young men with arterial blockage from a crotch injury or fracture of the pelvis, and even for them the success rate is only about 60 percent. If you do decide to have surgery, be sure to have it done by a skilled surgeon at a university medical center or by a doctor who specializes in vascular surgery. And get a second opinion before you make a commitment to have surgery.
Penile implants are the last resort for a man with ED. Of all the approaches discussed, implants require the most thought because they are basically irreversible. Implants replace the natural erection tissue, and although they can be removed, the chances of having a normal erection again are small. That being said, thousands of implants are done annually, and 90 to 95 percent of men who have them are satisfied and thrilled that they can again have sex.
There are two basic types of implants -- semirigid or malleable, and inflatable. Malleable implants consist of a pair of silicon rods placed inside the penis. With earlier models the man always had an erection. Newer models are more flexible and can be positioned against the leg for a more normal appearance and feel.
Inflatable implants imitate the action of a normal erection. A pair of hollow cylinders are placed inside the erectile tissue of the penis. Tubes connect the cylinders to a fluid reservoir and pump, all of which are surgically implanted inside the body. Today's state-of-the-art implant is a three-piece hydraulic implant, with a reservoir for inflation in the abdomen. When a man with this type of implant wants to have an erection, he inflates the cylinders with a small pump present in the scrotum. Inflatable implants seem more natural; the penis is soft when uninflated and hard when inflated.
Penile implants have been around for a long time now, are easier to put in than before, and are more effective than ever. They let a man have a good erection without shots, and, while they are expensive, they are covered by many insurance plans. Complication and infection rates are very low. However, since implants involve surgery, are basically irreversible, and involve risk, however slight, of mechanical failure requiring more surgery, anyone considering an implant really should get a second opinion and carefully pick a skilled surgeon. It's also a good idea to talk to other men who have an implant. Your physician should also be able to provide you with a video.
Erectile dysfunction can be a frustrating and embarrassing problem. Hopefully you have seen that erectile dysfunction is a medical condition like any other -- it can be diagnosed, treated, and, sometimes, even cured.
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This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.