Now experts are convinced that in most cases purely organic (that is, not psychological) causes result in erectile dysfunction. All the options of erectile dysfunction treatment are divided into conservative and operative.
Conservative options of ED treatment include drug therapy or the use of vacuum constrictor devices (vacuum pumps).
More recently, the main drug used to treat erectile dysfunction was Yohimbine. The effectiveness of its use does not exceed 10%. The need for long-term use of the drug (up to a year) and the low efficacy of treatment, a large number of adverse reactions make this method of treatment unacceptable.
Currently, Viagra (sildenafil), Levitra (vardenafil) and Cialis (tadalafil) from Sky Pharmacy have been successfully used to fight erectile dysfunction. The effectiveness of drugs is undeniable, but they can cause a lot of side effects. These treatment options may be bought over the counter.
Modern medical drugs (the so-called sexual stimulants), used in clinical practice, can achieve higher efficiency of treatment, which reaches 70-80%. These drugs are distinguished by the presence of side effects, such as a minor headache, sudden face and neck reddening, hyperemia of the nasal cavity, a change in color sensation and visual acuity.
Intracavernous injection of vasoactive drugs
The essence of this option consists of microinjections of vasoactive drugs directly into the penis before sexual intercourse. The method of intracavernous injections has become the most common and most effective among conservative methods of treating erectile dysfunction. For treatment, prostaglandin alprostadil is used, both as monotherapy and in various combinations.
The combination of drugs is used to reduce the side effects of each of them by reducing the concentration. An integrated programmatic approach to the prescription of intracavernous therapy allows us to make the use of this method effective and safe especially in comparison with herbal (natural) treatment options.
Intraurethral ED therapy
For intraurethral applications, various drugs are used, such as alprostadil. The drug is absorbed from the urethra and it enters the cavernous body from the bloodstream, where reactions occur that cause an erection. This method is similar to the previous one, but it eliminates the injection into the penis. Currently, this therapy is not widespread due to the high cost of drugs and adverse reactions (burning sensation in the urethra), as well as the need for mandatory use of a condom.
Vacuum constrictor erectile dysfunction therapy
The essence of this option is to create negative pressure in the corpus cavernosum using a vacuum cylinder and a pump, which causes blood flow and an erection held by a special compressive ring at the base of the penis, which restricts venous outflow. Thus, it becomes possible to perform sexual intercourse, lasting no more than 30 minutes. The effectiveness of this method is 40-50%. The disadvantages include the practical use of the device, painful ejaculation caused by a compression ring, penile hemorrhages, numbness of the penis, etc.
Surgical treatment options
Surgery has recently been used less frequently due to the high effectiveness of drug therapy. Surgical options for ED treatment are used in extreme cases, when conservative or natural treatment options do not give the desired results and for certain indications.
Surgical treatment of penile venous insufficiency is performed in the event of a lesion of the venous constricted mechanism. Despite the great age of this option, its effectiveness is about 50%. However, even with relatively low results, penile venous surgery is still used in clinical practice, as an adjunct to other previously cited methods, which allows achieving great outcomes.
Surgical treatment is indicated in the case of insufficient arterial blood flow to the penis. An arterial microvascular shunting is performed, the effectiveness of which ranges from 30 to 50%. This operation shows high efficiency only in young patients.
A prosthetic penis is currently the main method of restoring rigidity of the penis. Implantation of prostheses is the final stage of treatment of erectile dysfunction when all previous methods of treatment have already failed.
The main role is played by the three-step technique of focusing sensuality. This method recommends paying more attention to the satisfaction of the partner during sexual intercourse. At the first stage, the partners deliver mutual pleasure without genitalia contact. At the second stage, partners touch the genital and erogenous zones of the partner but do not start sexual intercourse. And only at the third stage sexual intercourse takes place.