Patients & Visitors

Urology

D11

Andrology Clinic

This clinic is for the evaluation and treatment of men who are finding it difficult to attain or maintain an erection sufficient for sexual intercourse.  The clinic is run by one of our Clinical Nurse Specialists.  In the clinic we look for possible causes of erectile difficulties and then agree a treatment plan with the patient.

Erectile dysfunction is a very common problem affecting about 1 in 10 men.  Unfortunately only a small proportion of these men actually receive any treatment for their problem.

Guidelines for Primary Care Management of Erectile Dysfunction


Causes of erectile dysfunction

Most men will, at some stage, fail to get or keep an erection.  The most common causes are stress, tiredness, anxiety or excessive alcohol intake.  If a man worries about the problem it can lead to further difficulties because of the "fear of failure".  Other problems that can contribute to a psychological cause of erectile dysfunction include:

  • Depression
  • Sexual boredom
  • Rows with your partner
  • Worries about sexual orientation

About 75% of men who have ongoing issues with erectile dysfunction will also have a physical reason contributing to their problem.  Men whose problem is predominantly a physical one tend to have a gradual onset of erectile failure that tends to occur persistently on all sexual activities.  Common causes include:

  • Diabetes
  • High blood pressure
  • High cholesterol
  • Side effect of prescribed drugs
  • Heavy smoking
  • Neurological diseases and stroke
  • Alcohol and drug abuse
  • Previous urological surgery (e.g. radical prostatectomy)

Treatment of erectile dysfunction

There have recently been major advances in the treatment of erectile dysfunction and the majority of sufferers can be treated effectively. The first step is to consider some lifestyle changes:

  • Stop smoking
  • Reduce alcohol intake
  • Try to reduce stress and anxiety
  • Lose weight

Psychological factors or relationship difficulties can sometimes be successfully addressed by a course of sex or couple's therapy.  Talking about and sharing the problem with your partner can sometimes dispel the "pressure to perform" that some men feel from their partner.

If these measures don't work there are a number of treatment options:

Tablets

Tablets are the first line in the treatment of erectile dysfunction.  You will no doubt of heard of Viagra but there are also another two similar tablets available.  During the clinic we will discuss these tablets with you including the potential problems with their use.

Injection

In this highly effective form of treatment the patient or their partner is taught to inject a drug directly into the shaft of the penis.  This results in an erection within about 15 minutes of the injection.  The procedure is easy to learn and relatively pain free.  This technique works for about 90% of patients.

MUSE

In this treatment a small pellet of drug is inserted into the urethra (water pipe) using a special disposable applicator.  This is pain free.  The drug is taken up through the wall of the urethra and passes into the erectile tissue.  It gives an erection in about 5-10 minutes.  The success rate is an erection in about 50% of attempts.

Vacuum pump

This device comprises a plastic cylinder connected to a pump, which is either hand or battery operated, and a tension ring.  The pump helps to draw blood into the penis and the ring is then placed around the base of the penis to maintain the erection.

Hormone treatment

Occasionally erectile dysfunction is due to a reduced level of the male sex hormone testosterone.  This is tested for and if found to be a problem appropriate testosterone replacement can be commenced.

Penile prosthesis

This is essentially a splint that is inserted surgically into the penis.  A pump is also implanted which is used to hydraulically inflate the prosthesis and allow intercourse.  This is the treatment of last resort as it means causing the destruction of the normal erectile tissue.


Further information

Sexual Dysfunction Association - Helpline  08707743571
The Sexual Advice Association, (formerly the Sexual Dysfunction Association), is a charitable organisation, to help improve the sexual health and wellbeing of men and women and to raise awareness of the extent to which sexual conditions affect the general population.

British Association for Sexual and Relationship Therapy
Previously known as the British Association for Sexual and Relationship Therapy, this is the national specialist charity for sexual and relationship therapy

Relate - Helpline  01788 573241
Relate offers advice, relationship counselling, sex therapy, workshops, mediation, consultations and support face-to-face, by phone and through their website



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