Health Care

by Alex Ellorde

Over the last few years, impotent men around the world have relied on some little blue pills to help them obtain and maintain their erections. But the pills are not without their complications. Some men experience side effects while taking oral phosphodiesterase type 5 (PDE5) inhibitors such as Viagra (sildenafil), Cialis (tadalafil) and Levitra (vardenafil). These side effects can range from headache, flushing of the face and body, indigestion, runny nose, palpitations, nausea, vomiting, muscle pains and vision disturbances. These medications are also contraindicated for patients taking nitrate-based drugs or alpha-blockers, because interaction with PDE5 inhibitors can be fatal. Viagra has also been reported to cause permanently impaired vision or even blindness in some patients. Other drug treatments available involve direct injections to the penis or shooting pellets down the urinary pipe, both of which can be unpleasant for patients. It is because of these side effects from drug treatments that some men prefer to explore other possibilities such as mechanical or surgical methods to deal with their condition.

There are a number of mechanical devices available to aid impotent men, such as vacuum pumps, penis rings and vibrators. Vacuum pumps are cylinders that fit over the penis, which allow the user to draw up blood to the member by sucking out the air. Once the member is engorged, a specially designed penis ring can be fitted on to the base of the shaft to help stop the blood from draining back to the body. Vibrating devices can also be used to vitalize the male member either by direct contact or by stimulating the prostate. Some men may feel too embarrassed to purchase such devices because of a social stigma attached to them. However, privacy issues can be dealt with by ordering these through the Internet.

On the other hand, surgery is a much more drastic step to take when dealing with impotence. Surgery usually has one of three goals: to implant a device that can cause the penis to become erect; to reconstruct arteries to increase flow of blood to the penis; or to block off veins that allow blood to leak from the penile tissues. Prostheses are mechanical devices that surgeons insert into the penis to allow men to manually raise or inflate the penis for sexual intercourse and to lower it afterwards. Patients can choose to have either a flexible sterile rod put into the shaft or an inflatable implant that comes with its own fluid reservoir and pump, although the latter is preferred because it leaves the penis into a more natural state. Possible problems can occur as with many other implants, such as bleeding, infection and the breakdown of the mechanical device although the latter has been somewhat limited because of recent technological advances.

There are cases of impotence that benefit from penile arterial revascularization. It is designed to keep blood flowing by rerouting it around a blocked or injured vessel at the base of the shaft, usually due to a pelvic fracture or blunt trauma. This procedure is recommended for men under the age of 45 with no known risk factors for atherosclerosis, a condition where progressive thickening and hardening of the walls of medium-sized and large arteries as a result of fat deposits on their inner lining. Surgeons microscopically connect nearby arteries to keep the blood circulating into the penis.

On the other hand, venous ligation surgery is done to correct leaking veins. This leakage decreases the amount of blood to the penis, thereby resulting in a diminished erection. Surgeons intentionally block off problem areas to ensure that the appropriate amount of blood is trapped to create an erection. However, ligation only has a 50% long term success rate so it is rarely used to correct impotence.

Patients who are considering vascular surgery should be aware that it is still widely regarded as experimental and may not be covered by your health insurance. There are also conditions that can exclude men from being a candidate for surgery, such as insulin-dependent diabetes, atherosclerosis, high blood pressure, high cholesterol levels and tobacco use. The procedures can also cause penile scarring(fibrosis), numbness or some pain.

It is important to discuss the possible complications with your doctor before consenting to any type of surgery. Also, because of the experimental nature of the procedures, not all urologists may be trained to perform the delicate surgery. If necessary, get a second opinion. It might be a better idea to try non-surgical treatment options before attempting anything invasive. Most importantly, don't forget that the brain is the primary sexual organ in the body. Being open with your partner about the condition and exploring other avenues of pleasure can be just as beneficial to you as any medical procedures.

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