Erectile Dysfunction: Current Concepts

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What is erectile dysfunction?
Erectile dysfunction, or impotence, is the inability to achieve and sustain an erection suitable for sexual intercourse. The condition is not considered normal at any age. Premature ejaculation, infertility, or low sex drive are not the same as erectile dysfunction, though one or more of these conditions may be associated with it.

How serious a problem is erectile dysfunction?
It is estimated that erectile dysfunction affects about 1 in 10 adult males on a long-term basis. A much more common problem that affects most men at some point is the occasional failure to achieve an erection. Occasional failure can occur for a variety of reasons, such as from drinking too much alcohol or from extreme fatigue. Failure to achieve an erection less than 20 percent of the time is not unusual and treatment is rarely needed. Failure more than 50 percent of the time generally signifies there is a psychological or physical problem (or combination of both) that requires treatment.

How is erectile dysfunction detected?
An erection is possible when three conditions are met:

  • The nerves to the penis must be functioning properly
  • The circulation to the penis must be adequate
  • There must be a stimulus from the brain (or spinal cord for a reflex erection)

If there is something interfering with some or all of these conditions, a full erection will be prevented. Treatment is directed towards correcting these problems.

What is the treatment for erectile dysfunction?
Non-surgical

  • Sex therapy
  • Viagra (sildenafil), Cialis (tadalafil), Levitra (vardenafil) -- these are oral medications to help achieve an erection
  • MUSE (Medication for Urethral Stimulation of Erection) Urethral suppository
  • Caverject (Penile injection of alprostadil)
  • VED (Vacuum Erection Device) -- these are suction devices with rubber constriction bands

Surgical

  • Penile implant (semi-rigid or inflatable)
  • Penile revascularization

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Last Updated: 7/15/2008

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