Endovascular Treatment for Erectile Dysfunction (ED)

Description

• addIndications

  There are many currently applied methods of ED treatment. They include conservative treatment, surgeries, and psychotherapy. The choice of the most appropriate course of management depends on the aetiology of the dysfunction, its clinical picture, and a joint decision of the specialist and the patient. In some cases, it is possible to combine pharmacology with surgery.

  1. Psychotherapy – if the sexual dysfunction has a psychological background, psychotherapy may bring about the desired results.

  2. Conservative treatment:

  Pharmacological treatment: – phosphodiesterase inhibitors(PDE5 inhibitors: Sildenafil, Vardenafil, Tadalafil).

  Testosterone – In patients with erectile dysfunction and decreased level of androgens (i.a. testosterone), oral, intramuscular, or transdermal (patches) supplements of testosterone may be administered.

  Other medicines used in the therapy of erectile dysfunction include: pentoxifylline improving blood flow, yohimbine (natural, herbal substance influencing the contractility of the vessels), as well as apomorphine.

  Injections to cavernous bodies

  3. Mechanical methods: vacuum penis pump: does not cure the cause and is only a symptomatic and supportive measure

  4. Surgery

  Penile prostheses

  Hydraulic penile prostheses

  5. Reconstructive surgeries: In case of injured sex organs or their vessels and nerves, it is possible to carry out reconstructive procedures. These are mostly very complicated and technically difficult to conduct procedures, and their effect may be unsatisfactory. However, for many patients, they may be the only therapeutic option of restoring normal erectile function.

  6. Intravascular procedures:

  Arteriography can aid in the diagnosis of macrovascular causes of ED by demonstrating significant atherosclerotic lesions proximal to the dorsal penile arteries. A reduction of luminal diameter by more than 50% in these vessels is thought to be significant.

  While long occlusions and intrapenile lesions are unlikely to benefit from angioplasty, short smooth stenoses (2–3 mm) in the internal pudendal and proximal common penile arteries, where approximately 70% of lesions are found, are amenable to percutaneous transluminal angioplasty (PTA).

• addBefore procedure - Preparation

  The preoperative assessment will establish if the interventional treatment is the best option for yout. Physical examination and imagistic tests are key elements which help making a decision.

  Prior to the intervention, the your doctor must be prevented about any history of allergic reactions. Blood tests are taken including hemoglobin level, coagulation, renal function, and other specific tests.

  The patient is admitted the day before the intervention, and he should not eat before the procedure.

  Your doctor will tell you if you should not use some drugs before the prcedure (e.g. PDE5i).

• addAfter procedure - Recovery time

  You will be given pain medication for incisional pain or you may have had an epidural during surgery which will help with postoperative pain.

  Since the procedure is minimally invasive, the postprocedural recovery is usually very fast. The majority of patients can leave the hospital the following day. Indications about recovery and postprocedural treatment will be clearly specified to all patients.

  Physical activity should be normal.

  Also, antiagregants drugs (such as Aspirin 100mg and Palvix 75mg ) are required for 6 months after procedure. In some cases (if you are know with conditions like diabetes or cardiovascular diseases) treatment duration may be longer.

• addOther information

  Is it painful?

  No, usually, the intervention is performed under local or general anesthesia.

  How long does it take?

  The duration of the procedure is about 1-2 hours.