Modern medicine has fundamentally new effective methods for treating erectile dysfunction at any age. German specialists use an integrated approach to treating erectile function disorders, including the treatment of major diseases, refusal of bad habits (dysfunction becomes less pronounced in 50% of people abstaining from alcohol), psychotherapy, use of therapeutic, and, if necessary, surgical treatment.
One of the most effective conservative methods of erectile dysfunction treatment is taking tablets of phosphodiesterase-5 type inhibitors - Viagra (sildenafil), Levitra (vardenafil), Cialis (tadalafil). They are used for all types of erectile dysfunction, regardless of what caused the violation. Especially effective these drugs are in the case when the disease is caused by vascular violations. There are contraindications to the use of phosphodiesterase-5 type inhibitors, the main of which is the patient receiving nitrates in any dosage form.
When there is a marked decrease in the level of androgens, combination therapy with testosterone preparations and phosphodiesterase-5 type inhibitors is carried out. Intracavernous injections of vasodilators - papaverine, phentolamine and alprostadil (prostaglandin E1) can be used to achieve and maintain an erection. In cases of sufficient blood supply to the penis and the absence of increased vein permeability, this procedure causes a persistent erection lasting an hour or more. The patient is taught to do self-injections. The injections are painless and do not affect ejaculation if done correctly. Possible side effects of the procedure - hematomas at the injection site, the development of infections, penile curvature. When conducting intracavernous injections, there is also a risk of developing priapism - an excessively long, more than 4 hours, erection, which, in the absence of immediate therapy with a-adrenal stimulants or sympathomimetics (phenylephrine, ephedrine), can lead to ischemia and subsequent fibrosis of cavernous fibrosis.
An erection can be achieved by introducing urethral suppositories with prostaglandin E1, with the help of special devices introduced into the urethra. The procedure is sometimes accompanied by soreness in the genital area in men and vaginal itching in women. Prostaglandin E1 can cause a reduction in female uterus, so when having sex with a pregnant woman, a condom should be used.
Local negative pressure therapy is an effective non-invasive way to restore erectile function. Its essence is to create negative pressure in the penile cavernous bodies using a vacuum cylinder and a pump, which causes blood flow and erection. The relative cheapness, low frequency of long-term complications are the advantages of using a vacuum device for erectile dysfunction treatment. The popularity of these devices has decreased slightly due to the emergence of new treatments.
Such new, promising methods of treatment of erectile dysfunction include stimulation of angiogenesis using shock-wave technology, contributing to the development of additional blood circulation in the penile structures. It leads to a qualitative improvement in erection. The impact of low-intensity acoustic shock waves on cavernous tissue does not lead to side effects. It allows treatment without pharmacological preparations and is highly effective.
In most cases, to achieve a positive result, a sufficiently adequate conservative therapy is used, but in some situations, specialists use surgical methods for treating erectile dysfunction, aimed at either restoring the normal blood supply to the corpus cavernosum or replacing nonfunctioning cavernous with a prosthesis. In cases erectile dysfunction is caused by irreversible damage of the arterial bed (stenosis due to trauma or atherosclerosis), pathology of the cavernous bodies (cavernous sclerosis, fibrosis) or severe venous insufficiency, arterial reconstructions and operations on the venous bed are performed. In the case of arterial insufficiency caused by occlusal lesions of the arterial bed, various options for bypassing of penile arteries are used, ensuring increased blood flow to the cavernous bodies. In case of excessive venous discharge (venous occlusive dysfunction), various operations are performed, the purpose of which is to eliminate the prevailing pathological venous outflow from the cavernous bodies by means of maximum permissible ligation of draining vessels. A worthy alternative to traditional methods of treating venous occlusive dysfunction is the newest high-tech operation - endovascular occlusion, which is highly effective.
Endofalloprosthetics is high-tech plastic surgery to implant special prostheses into penile cavernous bodies. This is one of the radical methods of treating organic forms of erectile dysfunction. Its effectiveness is largely determined by the qualifications of the surgeon and the quality of implants. The high efficiency of penile prosthetic surgery is achieved due to the extensive experience of such operations, the use of the most modern models of prostheses, distinguished by reliability and perfect design. In modern plastic surgery, various types of phalloprostheses are used, the most sophisticated of which are multicomponent hydraulic or inflatable ones. Their design allows the most accurate simulation of the physiologically penile natural state. Functional and durable models of phalloprostheses make it possible to permanently solve the problem of restoration of sexual function and thereby significantly improve the quality of life in most patients.