Men's Health Conditions

Erectile dysfunction

Commonly known as ‘impotence’, erectile dysfunction (ED) is the inability to achieve or maintain an erection that is adequate for sexual intercourse. It can affect one in ten men and more than 50% of men over 40 will experience some form of ED. Having erection trouble from time to time is not necessarily a cause for concern. However, on-going difficulty with erections may cause stress, affect your self-confidence and contribute to relationship problems.

Causes of ED can be physical or psychological in nature and your consultant will carry out a through examination and investigations to help determine the cause of the problem.

There are a range of treatment options for ED and these may include:

• Lifestyle advice.
• Psychosexual counselling.
• Testosterone replacement therapy.
• PDE5 inhibitors – these tablets are a very effective form of treatment and can work in up to 80% of patients. They work by temporarily increasing the blood supply to the penis. Examples include Sildenafil (Viagra), Vardenafil (Levitra) and Tadalafil (Cialis). Patients who take nitrate based medications for heart problems cannot use these medications.
• Pellets into the urethra – This Intraurethral pellet formulation (MUSE) is where a small pellet is inserted into the urethra at the tip of the penis. This causes the blood vessels to relax and increase flow.
• Injections into the penis – Intracavernosal injection therapy (Caverject, Viridal) is where the patient self-injects medication into the side of the penis. This causes the blood vessels to relax and increase flow. You will be taught how to administer the injections and what to do in the event when an erection will not go down.
• Vacuum device – a cylinder is placed over the penis and a vacuum is created with a pump. This creates an erection by drawing blood into the penis. This expands the spongy tissue which fills with blood, resulting in an erection. Once the penis is engorged with blood, a constriction ring is placed around the base of the erection. The constriction ring ensures that the blood remains in the penis to maintain a firm erection, until the ring is removed.
• Penile implant – Indicated for a very small number of patients where all other treatment strategies have failed. A penile implant is inserted into the penis under general anaesthetic. Your consultant will be able to discuss this in further detail with you.

For more information and to book a consultation please contact us.

Curved / Bent penis – Peyronie’s disease

Peyronie’s disease is a relatively common condition that results in curvature of the penis that subsequently makes sexual intercourse difficult or even impossible. The cause is often unknown but may be secondary to trauma following intercourse or a sporting injury. Scar tissue (fibrous plaque) develops along the shaft of the penis which is less flexible causing the penis to bend as it stiffens. Depending on the location of the fibrous plaque, the penis may bend upward, downward or sideways.

Symptoms often include painful erections and a curved, distorted penis.
The condition may clear up completely but in most cases men find the curvature stays the same or may even worsen. Treatment options depends on the severity of symptoms and may include medication, injections, vacuum / traction therapy or surgery.

If you have developed this condition and wish to seek medical advice then please contact us for a consultation

Interstitial cystitis (also known as Bladder Painful Syndrome)

Interstitial cystitis (IC) is a poorly understood condition that causes long-term pelvic pain and discomfort. It can affect both men and women, symptoms are often debilitating and can affect their lifestyle, work and emotional health.
No one really knows the causes of IC although several theories have been postulated and often no triggering factor is identified.

Symptoms vary from person to person and may include:

• Lower abdominal pain/bladder pain that may be constant or intermittent.
• Frequent need to urinate and often passing only small amounts.
• Urgent need to urinate that is difficult to defer.
• Blood in the urine and stinging or burning.
• Pain that worsens during menstruation in women.
• Scrotal and penile pain.

There is no one test that is specific for the diagnosis of IC and it is important to exclude other causes for these symptoms with investigations. Once a diagnosis is established it is important to note that there is no cure for IC and the goal of treatment is to relieve symptoms. Because IC is a chronic condition, most patients will need to continue treatment indefinitely to keep the symptoms from returning.

Edgbaston Urology Partnership can offer a dedicated treatment strategy to manage your symptoms and may include a combination of lifestyle changes, medication and minimally invasive surgical procedures.