Treatment methods for erectile dysfunction (impotence)

Low Intensity Sound Waves (LISW) therapy, also known as the RENOVA method, is a form of treatment designed for patients whose potency problems are caused by damage at the level of micro-vessels. During the therapy, the process of local controlled angiogenesis (the process of creating new blood vessels) in the penis is stimulated. The result of this process is the restoration of proper blood flow in the genitals and the restoration of their natural sexual function.

VEDI ClLINIC is the first and only clinic in Poland offering RENOVA therapy.

Most potency problems of vascular origin are related to the development of pathology at the level of micro-vessels. However, in some cases, pathology can also appear in the main arterial system (iliac and pudendal arteries). In these cases, treatment is used, which consists of unblocking the narrowed arteries using a special guide introduced into the interior of the vessel. This method is a form of balloon angioplasty (a minimally invasive cardiological procedure used, among others, in the treatment of coronary artery disease).

Due to the availability of oral medications and other less invasive and cheaper forms of therapy, classic methods of treating erectile dysfunction (impotence) such as penile implant surgery are used only in exceptional situations. However, penile implant surgery is a definitive method of treating erectile dysfunction and is commonly used when all other therapeutic options fail or if erectile dysfunction occurs as a result of oncological treatment (e.g. after removal of the prostate gland).

Reconstructive surgeries are performed on patients who have trouble achieving an erection due to trauma or congenital abnormality. During the surgery, the anatomical structures of the penis (including vascular and nervous structures) are reconstructed. Reconstructive surgeries are extremely difficult and require the cooperation of specialists from many fields of medicine. It should be noted that their success also depends to a large extent on the extent of the injury present in the patient.

The most common and one of the most effective therapeutic methods in the treatment of erectile dysfunction is currently pharmacotherapy using drugs from the group of phosphodiesterase inhibitors. The most well-known drugs from this group available on the Polish market are Viagra, Cialis and Levitra containing sildenafil, tadalafil and vardenafil respectively - active substances that, by blocking the enzyme phosphodiesterase type 5, provide increased blood flow to the corpora cavernosa of the penis. Drugs from this group are usually well tolerated by patients, but some men may experience headaches, dizziness, visual disturbances and hot flashes.

Since low testosterone levels are often associated with erectile dysfunction, some patients are recommended to take testosterone supplements. Oral preparations, intramuscular injections, and gels or special patches applied directly to the skin are usually used to raise low levels of sex hormones. Increasing testosterone levels in the patient's body increases libido and has a positive effect on well-being. Testosterone supplementation is usually used as a supplement to pharmacological treatment, but in some cases it can also be a stand-alone form of therapy. This is a treatment method that should be supervised by a urologist, andrologist, or endocrinologist.

Intracavernous injection therapy was first used in the 1990s, after it was discovered that papaverine (a substance that causes blood vessels to dilate and smooth muscle to relax) administered to the cavernous bodies of the penis causes an erection. Currently, preparations based on other substances are used, the most commonly used is alprostadil (a synthetic prostaglandin), which allows for an erection lasting up to several dozen minutes.

The patient can perform the injections themselves after being trained by a urologist. Alprostadil can also be purchased in the form of suppositories administered into the urethra (MUSE therapy). Because injections into the corpora cavernosa are associated with discomfort during application and can result in a number of undesirable side effects (including penile pain, priapism), they are not the preferred method of treating erectile dysfunction (impotence).

The most well-known and most popular mechanical method of supporting an erection in our times is a vacuum pump. An erection pump consists of a cylindrical container placed on the penis, a manual or electric pump and a pressure ring. The pump removes air from the inside of the cylinder, which results in the creation of a vacuum inside it. The presence of a vacuum causes increased blood flow to the corpora cavernosa of the penis and thus the appearance of an erection. After achieving a full erection, a pressure ring is placed at the base of the penis, which prevents the outflow of blood. Then the cylinder is removed. It should be remembered that the use of an erection pump is a temporary method that only removes the symptoms of the problem, not its cause.

In the treatment of impotence of psychological origin, the most effective method is undoubtedly psychotherapy. Psychogenic erection problems occur in men living in stress, suffering from depression or anxiety disorders, as well as those struggling with relationship problems. All of these problems can be solved during individual psychotherapy or psychotherapy for couples.

Since psychotherapy, unlike other forms of treating erectile dysfunction, is a long-term process that requires work on the part of the patient, if there are no immediate effects after the first few meetings with a psychologist or sexologist, one should not be discouraged and withdraw from the treatment. For psychotherapy to make sense, it is important to maintain its continuity and ensure the patient's own contribution.