Evaluation and Treatment
There was a time, in the not too distant past, that problems with sexual performance were kept in the closet. Neither patients nor physicians readily discussed them.
Today, all that has changed; the newspapers and TV are full of articles and ads about impotence.
Our experience, and that of many experts around the country, is that most sexual problems can be diagnosed and treatment started in 2 visits in a comfortable, confidential, and friendly ``physician directed" environment.
The major causes of impotence include: 1) abnormal blood flow to or from the penis, 2) neurologic illness, 3) some specific illnesses, 4) endocrine causes (abnormal hormone levels), 5) medications, and 5) psychologic factors.
WIth the advent of new oral medications to treat impotence, the management has been simplified. Often medicines are given to restore erectile function to patients.
For patients who do not respond to oral medications, other modern treatments are available including self injection of medication, vacuum erection devices, penile suppositories, and inflatable penile prosthesis.
Of course, the most important part of the evaluation is a careful history and physical examination by a physician, which is performed at the outset. In that way, we can determine which tests are of value, and which treatment is appropriate.