Category Archives: Erectile dysfunction

Opinion piece: Myths surrounding the investigation and treatment of erectile dysfunction (Part 6)

Opinion piece: Myths surrounding the investigation and treatment of erectile dysfunction (Part 6) There are instances where the onset of ED will not have the same impact on a couple’s relationship. Postprostatectomy ED, for example, is often accepted as part of the disease ‘package’ and can be successfully resolved, in most instances, without the partner’s participation in the treatment plan. It is difficult to find instances where couples therapy would not be beneficial, but certainly postsurgical ED is often handled with a more physiological approach, largely because the partner understands the etiology and does not feel, in part, responsible for the lack of tumescence. Similar attitudes are present in the partners of diabetic patients. Continue reading

Opinion piece: Myths surrounding the investigation and treatment of erectile dysfunction (Part 5)

Is there a subset of ED patients who can be managed in isolation? Conversely, should we insist on couple management with certain individuals?
Riley et al reviewed case records from 128 consecutive men presenting with ED whose partners attended on the first or second visit. The duration of ED varied from several months to 40 years. Interestingly, over one-half of the couples had not experienced any mutual sexual activity for about 2.5 years. Continue reading

Opinion piece: Myths surrounding the investigation and treatment of erectile dysfunction (Part 4)

Opinion piece: Myths surrounding the investigation and treatment of erectile dysfunction (Part 4) The ‘invested partner’, defined as a sexually normal individual within a couple invested in a relationship with a dysfunctional subject, traditionally was part of the treatment plan. It stands to reason that the use of vacuum devices, intracorporal injection therapy, MUSE or penile prosthesis implantation is best introduced with the invested partner’s knowledge because concealment is difficult and partner support is recommended for these treatments. Oral therapy has changed this because the erectile response is returned to its expected path and partner participation occurs through sexual stimulation. ventolin inhalers

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Opinion piece: Myths surrounding the investigation and treatment of erectile dysfunction (Part 3)

In a separate study by Lewis et al involving oral medication treatment, patient and partner satisfaction with sildenafil were measured using the ED inventory of treatment satisfaction questionnaire. A total of 247 patients with ED were treated in a randomized, double-blind parallel-group, multicentre study conducted through outpatient clinics. Continue reading

Opinion piece: Myths surrounding the investigation and treatment of erectile dysfunction (Part 2)

Does the partner need to be involved in the ED treatment plan?
We have all heard the story of the spouse who, after her husband receives a sildenafil prescription, complains to her physician, “I liked him better when he was impotent … he tried harder. Now he gets his erection and wants to use it right away.” Continue reading

Opinion piece: Myths surrounding the investigation and treatment of erectile dysfunction (Part 1)

Opinion piece: Myths surrounding the investigation and treatment of erectile dysfunction (Part 1) The realm of sexual dysfunction (SD), in particular erectile dysfunction (ED), has changed significantly over the past 20 years. ED was originally considered to be a nonorganic entity and, accordingly, much of the treatment by physicians was focussed on the psychosocial aspects of the patient and his partner. With increased focus on research in this area, there is now a better understanding of the pathophysiology of ED and effective treatments have been developed, including oral medications. As a result, there has been a paradigm shift from nonorganic roots to specific organic etiologies such as diabetes — buy diabetes drugs and atherosclerotic vessel disease. Continue reading