Erection problems

 

Erectile dysfunction or erection problems (including a bent erection) are common and will affect one in ten men in the United Kingdom. They become more common in later life. Over 50% of men over the age of 40 will experience erection problems at some point. In many cases the disease may be caused by other diseases such as diabetes, heart disease or previous surgery. Careful and sympathetic assessment is required in a discreet and relaxed environment. Modern treatments have become more effective at improving erections and can help patients to regain their confidence.

 

Investigations

 

As well as a careful assessment including the IIEF questionnaire (International Index of Erectile Function), some simple investigations are required in all men with erectile dysfunction. All patients should have some basic blood tests including a glucose test to look for diabetes and a testosterone level (the male hormone). If Mr Nayar is concerned about any other medical conditions that may contribute to your condition then he can organise appropriate assessment and treatment.

 

Treatment

 

Mr Nayar may recommend a range of treatments for erectile difficulties. These may include:

 

Ejaculation problems

 

Problems with ejaculation are relatively common and include: premature ejaculation, pain on ejaculation, retrograde ejaculation (little or no emission of semen) and delayed ejaculation.

 

Premature ejaculation is the commonest disorder of men aged less than 40, with at least 30% of men experiencing the problem. It is defined as persistent ejaculation before the wishes of both partners. It can happen for many reasons including anxiety, but rarely has a serious cause.

 

Pain on ejaculation can be associated with prostatitis, and retrograde ejaculation can be due to prostate surgery such as TURP or due to a problem of nerve control of ejaculation (a common cause of this may be diabetes).

 

A careful assessment is usually all that is required in all men with ejaculation problems.

 

Treatment

 

A range of treatments are available to treat ejaculation difficulties, they may include:

 

-counselling

 

-physical treatments

 

-tablets

 

-desensitising creams for premature ejaculation

 

Peyronie’s disease (bent erection)

 

A bent erect penis is relatively common, it may cause embarrassment, and if very severe it can cause sexual intercourse to be difficult, painful or sometimes impossible. Some men are born with a rare congenital curvature of the penis called chordee.

 

More commonly it is an acquired condition i.e. it develops over time: the condition is known as Peyronie’s disease. The cause of Peyronie’s disease is not known, it usually affects men in their forties or above, but it can be seen in younger men. In some studies the incidence is reported as high as 10 %. It is associated with age, obesity, diabetes and high blood pressure.

 

Investigations

 

A careful physical examination is often all that is needed in men with a bent erection, occasionally some simple investigations such as blood tests are recommended, especially if there are associated problems such as erection difficulties.

 

Treatments for Peyronie’s disease may include

 

Tablets

 

Surgery to straighten the erection

 

Penile prosthesis surgery