Falloprotezirovanie and classical methods of treating impotence

surgical treatments for impotence

Treatment of impotence is by far one of the most difficult tasks in urology.

The fact that none of the currently existing conservative metodovlecheniya not able stop the progressive development of the disease that eventually leads to complete loss of erectile function.

We can say that the solution to the problem was found in the methods of surgical correction of impotence, which currently have the highest efficiency, especially in the later stages of the disease [1].

Now, along with the traditional operations on the vessels of the penis, it is very widely used methods of prosthetics cavernous bodies, which helps to create an artificial genitals frame. Due to its high efficiency, they have received the most widespread [2].

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In which case, you need to have surgery for impotence?

Before talking about the indications for surgical treatment of impotence, it is necessary to understand what are the types and stages of the disease. Based on the causes of this pathological condition, impotence is divided into two main types: organic and psychogenic.

Not hard to guess that the first occurs on the background of any psychological or psychiatric disorders, and the second is caused by organic lesions of the reproductive system, in which can act as inflammatory, vascular, tumor diseases or injury sexual member [3].

In some cases, the causes of impotence can be combined in one and the same person. In such cases it is necessary to talk about a mixed form of the disease.

As for the stages of impotence, the two can be distinguished them conditionally:

• compensated
• decompensated

It characterized by first reversible physiological disorders erection process, and second, respectively, irreversible.

Absolute indication to Step impotence, erectile dysfunction, asthma is caused by organic disorders of the reproductive system. Simply put, the lack of erection on the background of the injury of the penis or its other diseases, can be removed only by surgery. [4]

As for other forms of impotence and stages, particularly one that is caused by psychological disorders, for example, unsuccessful sexual experience, in such cases, the operation should be used only when all other treatment options have been ineffective [5]. It must be remembered that the operation - a measure of the desperation and need to resort to it only at the last moment correction methods lifestyle, psychotherapy, and receive funds tablets do not bring even minimal positive changes.

* * *

To date, the surgical treatment of erectile dysfunction are two main types of operations:

• revascularization
• prosthetics

Male penis consists of two cavernous bodies, which during an erection are filled with blood, and thereby give the genitals appropriate form. When the impotence is disturbed physiological process.

operation used with a view to its recovery, which has the name revascularization penis [6].

The essence of this intervention is to increase blood flow to the body and thus increase the degree and duration of erection.

The essence of the penile prosthesis is the replacement of the corpus cavernosum of the artificial material, which gives the desired shape of the penis.

* * *

Equipment operations with impotence

Historically, surgeons tried to restore the physiological mechanism of erection, so at first appeared revascularization surgery penis.

Among the various modifications, considered the most successful revascularization corpus cavernosum by rear crosslinking vein of the penis and the inferior epigastric artery, which supplies the front abdominal wall.

During surgery, a small skin incision is made on the back of the penis with the transition to the stomach. In soft tissues secrete the dorsal vein of the penis, which is well visible under the skin, and the inferior epigastric artery, which goes up in the direction of the pubes.

Thereafter, data of two vessels sutured together so that their lumens were free compound. Due to the fact that the pressure in the artery is much higher than in the vein, blood flow is created by an additional anterior abdominal wall to the penis, which leads to increased erection.

Technique falloprotezirovaniyaotnositelno difficult, because during this operation, special prosthesis is implanted, giving the penis an appropriate form in the corpora cavernosa. There are two types of such prostheses: semi-rigid and pneumatic.

Semi-rigid prostheses are long plastic items that can be given the desired shape. For implantation performed a longitudinal incision of the skin on the lower surface of the body of the penis.

Thereafter, into the cavity of each of the corpora cavernosa is inserted in one semi-rigid prosthesis and the operating wound is sutured.

During the implantation of the pneumatic or inflatable prosthesis incision is carried out not only on the penis, but also along the skin of the scrotum.

The cavity cavernous bodies implanted one inflatable balloon, and in the scrotum and the tissue of the anterior abdominal wall mounted pump for inflating these same cylinders and a reservoir for storing the recovered air.

The essence of this prosthesis is that the pump, which is located in the scrotum, can inflate, thereby bringing the penis is erect. After intercourse, the air cylinders with the same pump is pumped into the tank placed in the tissue under the skin and the penis, so to speak, returns to the resting state.

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The postoperative period

The postoperative period is the most difficult point in the surgical treatment of impotence. Besides the fact that a man feels severe pain caused by surgical trauma, it may be difficult to adapt to the presence of foreign body in the tissues. At this time the patient is especially important to support, so in the postoperative period with sick often psychologists.

Complete healing of the surgical wound, usually occurs within 4-5 weeks. Through this time, the patient can begin to have sexual intercourse.

* * *

Efficiency of operation impotence

Under the efficiency of surgical treatment of impotence is meant not only to return the patient the possibility of mechanical intercourse, but also physiological pleasure. In other words, the purpose of the operation is not only to achieve an erection, but also the ability to perform full sexual intercourse with ejaculation.

Efficiency of operation depends on the type of surgery. It is lowest when the penis revascularization (60-70%). That is why from this method in most of the world is almost abandoned, using it only in cases where there is a diagnosed disease vessels of the penis. [7]

The highest efficiency operation is falloprotezirovanie (87%) [8].

Thus higher efficiency have precisely pneumatic prostheses corpus cavernosum, but, unfortunately, the number of implantations is limited due to the high material cost.

That is why in many developed countries, penile prosthesis on the organic impotence are paid for by government programs.

* * *

Complications and risks

The most frequent complications of these operations is an infection of the surgical wound. Most often it arises during implantation of the prosthesis in individuals with a chronic infection in the organism or suffering predisposing diseases, e.g., diabetes [9]. In cases of infection prosthesis resorting to re-operation to remove the implant.

After a course of antibiotic therapy necessary, may re-prosthetics in 6-12 months. Studies have shown that the efficiency of such operation reaches 82% [10]. For the prevention of this condition in recent years we have begun to use prostheses, containing antibiotics.

However, the risk of infection is lower with only 1%, and the cost is higher by several times.

Another complication following prosthetic penis should be considered as a violation of a mechanical prosthesis.

In most cases, this occurs with pneumatic models, which have a complicated construction and consist of several components.

In case of failure of the prosthesis, it must be replaced immediately, as in this case, it starts performing a third-party body function and will not be anything else but the risk of infection.

* * *

conclusion

Surgical treatment is the most effective treatment for impotence, although this does not mean that it should be used in all cases without exception.

The operation carries certain risks that, in some cases, may even lead to deterioration.

That is why, for the surgical treatment of erectile dysfunction only need to be invoked in cases where conservative methods have not proven their effectiveness.

Surveys for erectile dysfunction

Chances of recovery

symptoms of impotence

The bad coitus interruptus?

Chances of recovery

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A source: http://impotenzia.ru/archives/45

Impotence Treatment - Methods and Results

Impotence Treatment includes conservative and operational methods. Since the causes of impotence are different, and the methods of therapy will vary in individual patients. More likely to suffer erectile function due to organic disorders.

To begin the treatment of erectile dysfunction is necessary to get rid of the causes of it, or at least reduce the impact factor. Spending only symptomatic treatment is not rational and ineffective.

Techniques for the symptomatic treatment include the use of oral medications therapy via vacuum holding psychotherapy.

If these methods are ineffective, preference is given to the introduction of intracavernosally different drugs with activity against vessels of the penis.

This oral route of administration, intracavernous, Intraurethral, ​​transdermally, subcutaneously and rectally. In the first place are the intracavernous and oral administration.

The preparations used with injections:

• Papaverine. Inhibits antagonist action of the enzyme phosphodiesterase-5, thereby increasing the level of nitrogen in the blood, which leads to penile vasodilation.
• Prostaglandin. Inhibits the release of norepinephrine.
• Phentolamine. Applied in the treatment.
• Phenoxybenzamine.
• Intestinal polypeptide, active against vessels.

Lack injection method - pain and discomfort during administration of the drug.

Medical treatment option impotence

More recently, even in the pharmaceutical market demand was the drug Yohimbine. The specialists have proved its effectiveness is only 10% of cases. Methods of treatment in such medication was barely acceptable, because it had to take a long time, sometimes for years, noted a number of side effects.

Now successfully struggling with erectile dysfunction drugs Viagra, Levitra, Cialis. They are effective immediately, but have a lot of side effects. The main disadvantage of drugs - they do not affect the potency of the cause of the violation. These drugs are considered to be sexual doping, due to its effectiveness in the 70-80%.

The main side effects — vision changes, headache, swelling of the nose, redness of the face and neck.

As used drug alprostadil. This prostaglandin. It can be used as monotherapy and as part of combination therapy. Combine medication to reduce side their actions by reducing the concentration of each.

Introduction and intraurethral alprostadil possible. The substance is well absorbed from the urethra and enters into the cavernous body where the leads to the development of reactions causing an erection.

The method is similar to the previous one, but the positive difference it is the lack of injection into the penis.

Unfortunately, the technique has not been spread, as it is relatively expensive, and leads to the development of side effects such as burning sensation in the urethra, as well as the need for a condom.

Treatment of impotence vacuum

How can you still treat impotence? There is a technique using vacuum.

the basis of its — forming in the cavernous bodies of numbers of negative pressure, which is achieved by a vacuum pump or a cylinder.

The action of the vacuum leads to increased blood flow and filling of the cavernous bodies and superimposed ring based on penile venous blood does not back flow away. Sexual intercourse should not last more than 30 minutes.

The method hardly finds supporters, as connected with the inconvenience of using (much to the partner) as well as low efficiency, equal to only 40-50%. At the same time, men often complain of pain during ejaculation, numbness of the penis, the occurrence of hemorrhages on it.

Surgical therapy of potency disorders

Such an option is rarely used because of the high efficacy for the treatment of erectile dysfunction. Currently, impotence is treated by surgery only after failure of conservative methods, as well as for certain indications.

For example, surgical techniques are shown to men who have had a disruption venozapiratelnyh penis mechanisms. The plan is designed such treatment for a long time, but its efficiency does not exceed 50%. However, in practice, the operation is used as an addition to the methods listed above.

Surgery is indicated and with insufficient filling of the arterial genital organs, because of which develops and erectile dysfunction. Of the operations can be called microvascular arterial bypass surgery, which, however, is effective in young people.

Also, experts say that venous surgery is justified for those persons who have suffered injury pelvis, perineum, but vessels with no signs of atherosclerosis, other lesions which interfere with the normal operation of recovery authority.

Resolution of the problem of impotence by implanting

Is it possible to cure impotence in men with the ineffectiveness of the described methods? The decisive step is the implantation of prostheses in the penis. Approach is justified if inconclusive other methods. Falloprotezirovanie - a reliable way to restore erections.

Treatment with the impotence prosthesis has good results, according reviews patients. The convenience is that you do not feel the presence of a foreign body, it imperceptibly.

After the surgery, removing the need to use drugs, stimulants erection vacuum erectors. A man full erection and orgasm. Falloprotezirovanie allows men who are desperate to get a positive result.

About 92% of patients who underwent the procedure, as well as their partners, happy with the result.

Positive side — the possibility of operation at almost any age, unless there are contraindications.

The prosthesis does not affect the sensitivity of the body, a full sexual life is permitted only after 6-8 weeks after surgery. If you are installing a multi-component inflatable prosthesis, the patient is sewn under the skin of the tank with liquid and a pump.

Prostheses formed in size are introduced into the channel, which the surgeon makes a cavernous bodies, then wound sutured.

The method can not be used in patients who have problems such as the obliteration of the corpora cavernosa of the penis, they expressed fibrosis, fistula urethra cavernous, if at the time of surgery the patient has inflammation in acute stage.

Home Treatment

If the situation is not running, then the strength of potency can be affected by such methods of prevention and treatment of impotence in the home:

• First of all, you need to give up bad habits. It must become a way of life.
• Be sure to fill in the daily routine of exercise. Any physical activity have a positive impact on overall health. For men, there are special complexes of exercises aimed at increasing blood flow in the pelvic cavity, as well as to increase the production of hormones.
• Good nutrition, which includes products increase potency in men and are useful for prostate cancer, should become your habit. It vegetables (celery, garlic, onion, parsley), all kinds of nuts, ginger, vegetable oils, especially flaxseed and olive oil, meat and fish products, seafood.
• If there are indications, the doctor will prescribe the dose of medication based on the hormone testosterone. Find out what doctor first link cure impotence.
• How to get rid of impotence, using herbal remedies. Unexpressed potency disorders can be eliminated herbs, such as ginseng, eleutorokokk, Leuzea, Aralia.
• Impotence can be successfully treated with the help of massage. It is a known prostate massage, both external and internal, which is to carry out specialist.

Often you can find a description of the method of treating impotence Malakhov. It is based on the use of plant - erection stimulants, as well as various products based on them. Furthermore stimulation of the sexual sphere, their active substances rejuvenate the organism, update and stimulate metabolism.

The choice of treatment is always based on the patient's wishes, as well as expert advice. Surgical treatment is applied in extreme cases, often manages to defeat erectile dysfunction conservative methods, of which the man can choose the most convenient and affordable.

A source: http://repsys.ru/ed/lecheniya-impotentsii.html

Surgical treatment of impotence

Surgical treatment of impotence is required in the case of incapacity of the other methods of treatment of erectile dysfunction. This problem is quite common among men. In addition, erectile dysfunction in men is very "rejuvenated".

Often specialists diagnose impotence of a particular character in young people under 25 years. consult your doctor for help in a timely manner is very important. There is a high probability that surgery can be avoided.

But, unfortunately, many of the stronger sex are used to hide the problem, ignore its initial manifestations. Therefore impotence detected already at an advanced stage.

Causes of impotence

Before starting treatment for impotence is important to identify the root cause of the disease. After treatment depends entirely on the fact that the impetus for the development of erectile dysfunction.

Specialists conditionally divide all causes of impotence into two groups: psychological and physiological. In the case of psychological impotence surgery is not required.

Conducted psychotherapy, drug therapy, lifestyle changes. can be attributed to psychological factors are:

• Frequent stress;
• Conflict situations;
• Fatigue;
• Insomnia;
• Excessive physical and mental stress;
• Diffidence;
• Fatigue, malaise organism;
• Dissatisfaction with their sexual partner;
• Depression;
• Unsuccessful first sexual experience.

In such cases, doctors usually recommend to adjust work and rest, to observe proper nutrition.

Also, it can be assigned to some sedatives for the normalization of the central nervous system. But physiological impotence can require surgery.

This type of erectile dysfunction triggered by certain diseases and organ systems of the body.

Very often with age in men have problems with the cardiovascular system. It is the poor condition of the vessels and is the primary cause of impotence in men. The thing is that the erection occurs when the active blood flow to the penis through the arteries.

Blood filled the cavernous and cavernous bodies, which are shrouded in spongy body. As a result, the penis increases in size. The outflow of blood is simply blocked. This allows you to make a full sexual intercourse. If a man has problems with vascular permeability, significantly increases the risk of impotence.

In many cases, vascular impotence is required surgical treatment.

Can lead to impotence and dysfunction of the endocrine system. In particular hormonal failure, wherein the output drops sharply male hormone testosterone. In this case, reduced libido level. Over time, the pelvic congestion formed.

Fainting and blood flow to the penis. Deteriorating vessels and endocrinological diseases such as diabetes. Surgical treatment requires and impotence on the background of a spinal cord injury and the spine.

Among other physiological causes of impotence can be noted as follows:

• Neurological disease;
• heart attack;
• Obesity;
• Injuries of the penis;
• Pathology of the genital organs;
• Frequent injections into the region of the corpora cavernosa of the penis;
• Chronic prostatitis;
• Infectious diseases of the urogenital system;
• Sexually transmitted diseases.

In most cases, treatment of impotence passes through medicinal preparations. Modern medicine offers a wide range of such funds. Today, surgical treatment of impotence is used rarely, and only in extreme cases. There are three common types of surgical intervention in the case of impotence:

• Venous Surgery of the penis;
• Revascularization of the penis;
• Endofalloprotezirovanie.

venous surgery

This method of surgery is required for vascular and venous impotence. In general, the venous treatment is necessary in case of damage venookklyuzivnogo mechanism penis. This venous surgery may be of such species:

• Ligation of corporal veins;
• Resection emissarnyh veins;
• Endovascular embolization of veins of the penis;
• Ligation of the legs of the penis;
• Spongiolizis.

Typically, venous surgery operations are not carried out independently. It is always a complex method of treatment which also requires taking certain medicinal drugs. It is often carried out resection of pathological sections of blood vessels and veins, which impede blood flow to the cavernous bodies of the penis.

Revascularization of the penis

This operation is a microsurgical intervention. This method of treatment also has several options. The most popular is the operation called Michal 2.

In this case, the surgeon makes anostomoz in the space between the bottom of the artery and dorsal artery polovogo male member. In surgical treatment of impotence, and are the method of Virag 5.

Thus, formed between the lower anostomoz epigastric artery and deep dorsal vein.

Endofalloprotezirovanie

Such an option of surgical treatment of impotence is the most effective. Men with this problem it helps in 92% of cases.

Penile erection is restored by the introduction of implants and prostheses inside the cavernous body of the penis. This operation allows the prosthesis to return the elasticity of the penis.

There are two types of prostheses: inflatable and plastic. The latter have the form of two rods, which are regulated. They are introduced into the male sex organ.

An erection is achieved in this case by setting the penis by hand. Internal rods take any shape. Therefore, to make a full sexual intercourse the man can at any time. Inflatable implants are defined as reservoir fluid. They are surgically installed into the abdominal cavity.

A two cylinder placed in the penis. Male compresses the pump, the liquid starts flowing into the cylinders, and thereby is achieved an erection. This method of surgical treatment of impotence will slightly increase the size of the penis in the flaccid state.

But if a young person has a communicable disease of genital organs, prosthetics prohibited.

A source: https://cavalero.ru/impotenciya/xirurgicheskoe-lechenie-impotencii.html

Impotence

Impotence - a violation of potency, impotence, manifested in man's inability to perform sexual intercourse. Often a manifestation of the underlying disease and its cure is eliminated (endocrine, nervous, cardiovascular disorders, genitourinary diseases sphere).

Erectile dysfunction can cause deep psychological depression, disharmony sexual and family relations.

Erectile dysfunction or impotence is manifest inability to achieve an erection sufficient for full sexual intercourse with preservation psychological comfort during it.

Impotence - violation of potency, impotence, manifested in man's inability to perform sexual intercourse.

Often a manifestation of the underlying disease and its cure is eliminated (endocrine, nervous, cardiovascular disorders, genitourinary diseases sphere).

Erectile dysfunction can cause deep psychogenic depression, disharmony sexual and family relations.

Erectile dysfunction or impotence is manifest inability to achieve an erection sufficient for full sexual intercourse with preservation psychological comfort during it. In recent years, the pathogenesis and causes of erectile dysfunction have been studied in order to restore normal sexual life and to date, the problem of impotence is not intractable.

The physiology of erection and detumescence

Smooth musculature of cavernous bodies and the walls of arteries and arterioles operate the main function in the process of erection and detumescence process - decline in erection after ejaculation or due to the reasons that prevented completion of the natural sex act.

When resting, the smooth muscles of the penis is influenced by the sympathetic nerve endings. At the time of sexual arousal or penis stimulation pulses transmitted by the parasympathetic nerve fibers, cause the release of neurotransmitters of erection, comes blood filling the cavernous tel.

This complex chemical process is the obligatory participation of nitric oxide. Initially, there is relaxation and relaxation of smooth muscles, which in turn contributes to the smooth blood supply. Increasing in size from the incoming arterial blood cavernous body partially block the outflow of the venous blood.

Because of the difference in the amount of blood intracavernous pressure inflow and outflow is increased, which contributes to the development of a rigid erection.

Immediately after ejaculation, stop sexual stimulation or the reverse process begins for other reasons - detumenstsentsiya. After activation of synaptic structures in the blood stand out neurotransmitters such as norepinephrine and neuropeptide.

Both of these processes are controlled by the average preoptic area of ​​the cerebral cortex, in general, sexual activity and sexual behavior of men dopaminopodobnyh depends on the concentration of substances possessing a stimulating effect and seratoninopodobnyh that have an overwhelming action. Abnormalities in any link of the whole process can lead to impotence.

Depending on the pathogenesis of erectile dysfunction emit several types of impotence.

psychogenic impotence It can be both permanent and temporary, such kind of impotence can occur in men who undergo frequent mental and physical fatigue, with a certain psychological difficulties or trouble finding partner. Temporary psychogenic impotence passes after the normalization of life.

psychogenic impotenceIn the pathogenesis of which lies sensitivity lowering cavernous tissue to neurotransmitters due to the overwhelming influence of the cerebral cortex or from indirect influence through the spinal centers, it may be in the background of sexual phobias and deviations, psycho-associative and religious prejudice. Today, thanks to the development of diagnosis between true and psychogenic erectile dysfunction, psychogenic impotence in its pure form, such as happens in case of serious sexual deviations (Pedophilia, zoofiliya) diagnosed less.

neurogenic impotence It occurs against a background of injuries and diseases of the central nervous system and peripheral nerves. Pathogenetic link is a difficulty or a complete lack of transmission of nerve impulses in the cavernous body.

The 75-% of cases of impotence are neurogenic cause spinal cord injury. The remaining 25% are neoplasms, cerebrovascular disease, herniated intervertebral, multiple sclerosis, syringomyelia, and other neurodegenerative diseases.

arteriogenic impotence is an age-related pathology as coronary atherosclerotic changes and penile vascular identical.

At an early age arteriogenic impotence can occur due to congenital anomalies of the vessels, smoking, hypertension, diabetes or due to injury.

Poor inflow of arterial blood is not able to fully feed cavernous tissue and vascular endothelium, disturbed local metabolism, which may lead to irreversible dysfunctional disorders cavernous tissue.

Pathogenesis venogennoy impotence poorly understood, but its development is promoted in violation of the venous bloodstream, where the lumen of the veins increases.

This happens when ectopic drainage of the corpora cavernosa of the penis via venous vessels, traumatic rupture of the tunica albuginea, resulting develops its failure.

Venogennaya impotence often accompanies Peyronie's disease and functional impairment the cavernous erectile tissue. Smoking and alcohol abuse exacerbates symptoms venogennoy impotence.

hormonal impotence most often develops on the background of diabetes, since diabetes changes the penile blood vessels and erectile tissue is quite serious.

But at the same time the cause of hormonal impotence not only in reducing the level of testosterone, as in violation of its digestibility, because patients with hypogonadism in stimulating erection problems are not observed.

But hypogonadism and male menopause hormone replacement therapy is conducted as a primary treatment for erectile dysfunction.

It may cause impotence and cavernous insufficiency or dysfunction of the cavernous tissue. The pathogenesis of this form of impotence are change corpus cavernosum, vessels and nerve endings that disrupts erektornogo mechanism.

kidney disease, in which the extracorporeal dialysis patients is shown in half of the cases are combined with erectile dysfunction, the two thirds of patients after renal transplantation restore erectile ability.

Prostatitis can cause impotence, both because of the lack of testosterone in the blood serum and because of circulatory psychogenic disorders: pain during ejaculation, premature ejaculation and iatrogenic states in which the syndrome is generated failures.

In patients with asthma, in the post-infarction state of impotence is caused by the fear of exacerbation of the disease during sexual intercourse.

Prostatitis is not a major cause of impotence, it can only aggravate its course, it should be keep in mind, as the majority of men believe that only prostatitis can cause erectile dysfunction.

All diagnostic procedures are intended to determine the cause of impotence, which means the ability to restore erectile function and elimination of emotional distress. To do this, we must first differentiate psychogenic and organic impotence.

A simple and reliable method is to monitor nocturnal erections and intracavernous injection test (Kaverdzhekt-test). If according to these methods is confirmed by the nature of the organic impotence, then conduct a series of additional tests to identify the underlying cause.

impotence treatment

Modern andrology has a sufficiently wide range of schemes and methods of treatment of erectile dysfunction. The choice of treatment is based on the decision on the admissibility of Andrology and use for a given patient.

Drug therapy for impotence is the traditional method of treatment, usually resort to testosterone replacement therapy and drugs from the group of blockers.

On the background of the main treatment is carried out periodically as the status of such preparations trazodone, trimipramine, nitroglycerin, metahlorfenilpiperazin - they are used in the form of ointment applications. The effectiveness of drug therapy does not exceed 30%, so the drugs are shown not all patients.

Psychotherapy may be the primary treatment for psychogenic impotence and neurogenic but provided that the therapeutic procedures are performed professionally.

Vacuum erectile therapy, which was developed in 1970 by Dr. D.

Osbon, when properly enables efficiency to 83%; Complications in the form of petechiae, painful intercourse occur in rare cases.

Intracavernous drug therapy is a relatively new method of treatment of impotence.

For the first time intracavernosally to improve erectile function were administered papaverine (1982), and then started using phentolamine, prostaglandin E1 and other drugs.

Minimal side effects, high efficiency and ease of use enables the preparation of prostaglandin E1; the use of this technique in 80% of cases, allows high-quality sexual life without any restrictions.

When using papaverine and phentolamine for intracavernous drug therapy in impotence as complications sometimes occur priapism and cavernous fibrosis that using prostaglandin E1 is extremely rarely.

The only drawback of this method is the treatment of impotence soreness injection, and after injection of prostaglandin E1, for pain injected 7.5% sodium bicarbonate.

Since this method of impotence treatment with minimal intervention gives good results, develop no injection technique intracavernous doing drugs.

Intracavernous falloprotezirovanie was first successfully performed in 1936 by the Soviet professor Bogoras, as the prosthesis was used costal cartilage. And in the mid-70s intracavernous falloprotezirovanie it has been widely used to treat impotence.

To date prostheses have different principles of action and give complete freedom to lead a normal sexual life.

Reliability of systems that are used for prosthetics and quality of technology will reduce the number of complications to 3.5-5%, and among patients using falloprotezy to correct impotence, more than 80% give good recommendations given technique.

Moreover, if the character has an organic impotence, patients should be encouraged to spend faloprotezirovanie immediately.

Because according to statistics the majority of men who use falloprotezy, first used drug therapy, vacuum therapy and intracavernosal self-injection.

The main reason that intracavernous falloprotezirovanie preferred by most patients, faced with the problem of impotence, This is a natural erection, no need for painful injections and continuous drug administration and the minimum number of complications.

A source: http://www.krasotaimedicina.ru/diseases/zabolevanija_andrology/impotence

Impotence: modern methods of treatment

Conservative treatment of erectile dysfunction

Surgical treatment of erectile dysfunction

Identification of psychogenic erectile dysfunction requires the help of an expert sexologist or psychologist and appropriate therapy.

The organic nature of erectile dysfunction requires treatment in an andrologist or, in the absence of an andrologist, urologist. Furthermore, it may be necessary to attract other doctors.

Treatment is:

• Conservative (therapeutic treatments):
• non-invasive (no injection);
• invasive.
• Operational (surgical techniques).

Medicaments for oral administration, vacuum-constrictor device and intracavernous injection - the basis of the conservative treatment of erectile dysfunction.

Qualified treatment of erectile dysfunction may be imposed or carried out by a specialist!

Conservative treatment

drug therapy

• Hormonal medicines:
• phosphodiesterase-5 in the form of tablets;
• drugs based on the type of prostaglandin E1 (alprostadil - injection into the penile cavernous body or applications into the urethra);
• alpha2 adrenergic blockers type receptor;
• vegetable (medicinal plants extracts);
• Homeopathic drugs (antibodies to prostate-specific antigen and / or a mixture of homeopathic dilutions of affinity-purified antibodies to endothelial NO-synthase);
• angioprotectors (protectants vessels from damage);
• biogenic stimulators (medicinal plant extracts for systemic and topical);
• adaptogens (ginseng extract Leuzea, Rhodiola rosea, tincture aralia, Eleutherococcus, Pantocrinum and others), but they should be used with caution at elevated pressure;
• means extending receptacles;
• vitamins and vitamin complexes.
• hormonal:
• androgens (if confirmed in the study of the lack of sex hormones!).

Vacuum-constrictor therapy

Vakuumterapiya otherwise - vacuum-constrictor therapy with external devices, LOD-therapy.

Pump cylinder upon application of negative pressure is created in the corpora cavernosa of the penis. This causes the flow of blood and an erection. To consolidate the effect on the base member is applied a special ring that prevents the outflow of blood.

The main disadvantages of the method:

• the need to use, often in the presence partner;
• possible discomfort during sexual intercourse and ejaculation;
• the possibility of bleeding after use.

intracavernous injections

Administration by microinjection of drugs, dilates blood vessels directly into the penis before intercourse. The active principle of prostaglandin therapy and systems based on it.

The main drawback - the constant trauma of the corpora cavernosa and, as a consequence, the risk of sclerotic lesions.

urethral application

There also exist various vasodilators. This technique avoids injections into the penis.

Disadvantages:

• The high cost drugs.
• Discomfort in the urethra.
• The need to use a condom in contact with pregnant women or women planning pregnancy.

Surgical methods:

• Revascularization of the penis.
• Falloendoprotezirovanie:
• semirigid endoprostheses (constant erection)
• pumped multicomponent implants (erection on demand)
• implants with integrated pumping system (erection on demand).

Indications for surgery:

• Lack of effect of medical treatment;
• Somatic (organic) erectile dysfunction;
• The need for reconstruction (rebuilding) of the penis (neophallus).

If conservative treatment does not give the desired results, as well as the presence of certain indications, Surgical techniques are the only possible alternative restoration of erectile function.

When venous insufficiency of the penis shows the operation to restore "venozapiratelnogo" mechanism.

Although the efficiency of the operation is not more than 50 percent, in combination with other methods, it provides a high quality of life for patients.

Subspecies of this technique - Rentgenoehndovaskuljarnaja occlusion (REO) vein - a relatively low-impact operation with the use of high-tech achievements (local anesthesia, good efficiency).

With a lack of arterial blood flow is carried microvascular grafting efficiency is 30 - 50%. The best effect is achieved in younger patients.

Endoprosthesis penis (falloprotezirovanie)

It is implantation (implantation) special synthetic devices (prostheses) into the corpora cavernosa - stiffening.

Here are the main types of falloprotezov: semi-rigid prostheses, plastic prosthesis, functional (inflatable) prostheses.

Semi-rigid falloprotezy most are easy to install and relatively inexpensive plan.

Disadvantages:

• Unpleasant sensations (due to the constant tautness penile tissue on the prosthesis).
• Cosmetic inconvenience (the need to hide under clothing permanently enlarging the penis).

plastic falloprotezy This layer system of silicone cylinders, which are located in the center of the wire strands of silver. Penis "extendible" hand up - for sexual intercourse, and after - to reduce the length goes down.

This type of prosthesis is relatively cheap and reliable. Disadvantage - a constant solid state of the penis.

Functional (inflatable) falloprotezy - as well as possible mimic the softness of a member in the "quiet" state.

It is filled with fluid cylinders implanted in the cavernous body of the penis. The cylinders are connected with a reservoir of sterile water (installed behind the pubic symphysis) and a pump-pump (located in the scrotum).

Erection patient presses on the pump and the fluid fills the cylinders inside the penis. To stop the erection also requires pressing the pump.

Such prostheses cosmetically and functionally the most close to the ideal.

Disadvantages:

• Quite a complicated operation to install.
• Expensiveness.
• A breakdown in the (rare).

When falloprotezirovanie important as the operation itself and the postoperative period.

To prevent complications need to:

• Strict adherence to medical doctor's appointments.
• Bed rest for 2-3 days after surgery.
• Break in work - at least 2-3 weeks.
• Sexual debut - 6-8 weeks.

Falloprotezy not reduce the sensitivity of the penis, do not affect the quality and quantity of orgasms or sperm quality. Patients appear ability to repeated sexual acts.

A source: http://www.medkrug.ru/manual/show/impotenciya__sovremennye_metody_lecheniya