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Dr. Raman Tanwar

Urologist and Andrologist

Erectile Dysfunction

Erectile Dysfunction is Treatable !

Erectile Dysfunction is a very common problem but with difficult solutions. Erectile dysfunction needs a thorough and detailed assessment for permanent cure and many times the cause needs to be emphasized to the patient again and again through multiple visits. Not all erection problems are simple to treat especially those that are deep rooted. Erectile Dysfunction may need varied treatments ranging from medicines to injections, shockwave therapy, Vaccuum devices and Penile Implants. All you need to do is choose the right and qualified expert for your sexual dysfunction

Browse through this page to know more about erectile dysfunction including its causation, investigations and Management by leading expert and authority on Sexual Dysfunction in India, Dr. Raman Tanwar

How does erection work ?

Fantasy is Created
Fantasy is Created

The Brain

Brain is the seat of creation of your fantasy. Erection can only happen once the desire comes and the signals are produced in the mind.

This step can be affected by Anxiety, Stress, Poor Environment, Inappropriate partner, Conditions of the mind such as dementia, stroke, and even the fear of performance
Signals travel through the nerves
Signals travel through the nerves

Spine and Pelvic Nerves

Signals of the brain travel via the nerves of the spinal cord and the pelvic nerves to reach the penile arteries.

Problems in the nerves such as neuropathies, demyelinating disorders, compression of the nerves, injury or surgery and chronic conditions such as diabetes can cause damage to the nerves.
Artery widens and blood flows in
Artery widens and blood flows in

Penile Artery

Once the signals reach from the brain to the penile artery via the nerves, a special substance called Nitric Oxide is released and this leads to widening of the artery and increase in the flow of blood into the penile sponge.

Blockage of the arteries due to atherosclerosis, dyslipidemia and endothelial dysfunction can cause arteriogenic impotence.
Penile Sponge gets filled with Blood
Penile Sponge gets filled with Blood

Corpora Cavernosa (Penile Sponge)

The penis has two large cylinders made up of spongy sinusoidal tissue. As the blood in the artery increases the cylinders start to fill up.

Injury to these cylinders and fibrosis such as due to traumatic sex or masturbation and diseases such as diabetes, dyslipidemia and endothelial dysfunction can lead to shrinkage in the sponge and Erectile Dysfunction.
The Veins are blocked by the Penile Sponge
The Veins are blocked by the Penile Sponge

Penile Veins

As the cylinders expand, they press the veins surrounding them and the flow of blood out of the veins stops. The blood keeps coming into the cylinders but is unable to escape and leads to a turgid or hard erection.

Veins may become hard or stiff with ageing and other chronic conditions such as diabetes. Due to stiffness they are unable to compress completely and blood may continue to leak. This causes Venogenic Impotence

Types of Erectile Dysfunction

  • Psychogenic ED
  • Organic ED
Psychogenic EDOrganic ED
Affects Young Men
Mainly due to anxiety and underconfidence
Affects Older Men
Results from actual disease of the organs
CauseMind is Unable to Produce the fantasy or signals for erectionProblem in the Arteries, Nerves, Veins or Spongy Tissue of the Penis
EvolutionSudden in onset and also goes away quickly if treated in timeHappens slowly over time and takes longer to recover with medicines
TreatmentCounselling and medical treatment alone is sufficient in most cases Long term medications, lifestyle changes and advanced therapy may be needed
Recovery TimeUsually within weeks to monthsMay require long term medications and even surgical options
Read MoreLearn More

Treatment of Erectile Dysfunction

Medicines are the first line of therapy for Erectile Dysfunction Treatment. 

Vaccuum Erection Devices can provide support to elderly patients with erectile dysfunction who are not benefitted by medications alone. This involves applying a ring at the root of the penis and using a pump based vaccuum device to engorge the penis with blood. 

Intracavernosal Injections are a sure shot way to get an erection. BIMIX or TRIMIX are two commonly available injection preparations that can be injected right before intercourse to get a hard erection. The problems associated with injection therapy are that the injections may be painful and may result in a state of prolonged erection called priapism that requires emergency care.

The healing properties of blood and various other factors can be used to treat erectile dysfunction. Patients blood sample is taken and platelet rich plasma is extracted out and injected at multiple points in the penis. The various growth factors present in this plasma lead to development of new blood vessels and improve blood flow to the penis. This therapy is presently experimental and is only useful in patients with mild to moderate erection issues of arteriogenic nature.

Just like PRP therapy, Low Intensity Shock Wave therapy has also been found to be very useful in the treatment of mild to moderate vasculogenic ED. Multiple sittings are required for sustained effect but with continuing lifestyle changes this can be long term solution for some patients. 

Penile Implant Surgery is the best treatment for refractory Erectile Dysfunction. You can read more about penile implants on this page.

Have more Questions ?

We would love to help you out with your doubts and questions. Let’s meet in person and discuss your problems at length. Dr. Raman Tanwar is a leading penile implant surgeon of India and offers all possible solutions for erectile dysfunction. Schedule your appointment today !

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