-->
                                                    
                                           JEEWAN MEMORIAL HOSPITAL FOR UROLOGY AND PLASTIC SURGERY

                

Male Infertility

 



For men, one of the most common sexual problems is impotence , also known as erectile dysfunction . Decreased sexual desire also may be a problem for some men.

Impotence

Three important steps are necessary to produce and sustain an erection .

1. The first is sexual arousal , which can come from the senses and from thoughts.

2. The second step is the nervous system response , in which the brain communicates sexual arousal to the body's nerves , including the nerves in the penis.

3. The third step is a relaxing action of the blood vessels that supply the penis, allowing more blood to flow into the shafts that produce the erection.

If something affects any of these factors or the delicate balance among them , impotence can result.



The basics

Impotence is a persistent inability to obtain an erection or to keep it long enough for sexual intercourse. Diminished sexual desire or even the loss of sexual desire isn't the same as impotence. Impotence refers to the inability to use the penis for sexual activity even when desire and opportunity are present.

An occasional episode of impotence happens to most men and is perfectly normal. In most cases it's nothing to worry about . As men age , it's also normal to experience changes in erectile function. Erections may take longer to develop, may not be as rigid or may require more direct stimulation to be achieved. Men may also notice that orgasms are less intense , the volume of ejaculate is reduced and recovery time increases between erections.

When impotence becomes a persistence problem, however , it can damage a man's self image as well as his sex life. It may also be a sign of a physical or emotional problem that requires treatment.

You may view impotence as a personal or embarrassing problem , but it's important to seek treatment , especially if a physical cause might be to blame. In many cases , erectile dysfunction can be successfully treated.

Risk Factor

A wide variety of physical and emotional risk factors can contribute to impotence . They include :

1. Physical diseases and disorders . Chronic diseases of lungs , liver , kidneys , heart , nerves , arteries or veins can lead to impotence . So can endocrine system disorders , particularly diabetes. The accumulation of deposits (plaques) in your artries also can prevent adequate blood from entering the penis. And in some men , impotence may be caused by low levels of the harmone testosterone .

2. Surgery or trauma . Surgery for prostate or colorectal cancer may result in problems with impotence . Injury to the pelvic area or spinal cord also may cause problems.

3. Medications . A wide range of drugs - including antidepressants , antihistamines an medications to treat high blood pressure , pain and prostrate cancer - can cause impotence by interfering with nerve impulses or blood flow to the penis . Tranquilizers and sleeping aids also may pose a problem.

4. Substance abuse . Chronic use of alcohol , marijuana or ther drugs often causes impotence and decreased sexual drive.

5. Stress , anxiety or depression . Psychological conditions also contribute to some cases of impotence.


Treatment
 
Treatment for impotence includes everything from medications and simple mechanical devices to surgery and psychological counseling . The treatment our doctor recommends will depend on the cause and severity of your condition.

Psychological counseling: If stress, anxiety or depression is the cause of your impotence, your doctor may suggest that you. or you and your partner, visit a psychologist or psychiatrist with experience in treating sexual problems.

Oral medication: Oral medications(Cialis, Levitra, Viagra,Androz,Caverta, Tadalis,Filda) enhance the effects of nitric oxide, a chemical messenger that relaxes smooth muscles in the penis. This increases blood flow and allows a natrual sequence to occur - an errection in response to sexual stimulation. Although these midications cn help many people, not all men can or should take them to treat impotence.

Alprostadil: Alprostadil (Caverject, Edex, others) helps relax smooth muscle tissue in the penis, enhancing blood flow needed for an errection. There are two ways to use Alprostadil . With needle-injection therapy, you inject the drug into the base or side of your penis. With intra-urethral theraphy you use an applicator to insert a medication pellet through the penis tip.

Hormone replacement theraphy : If you are among the small number of men whose impotence is related to hormone deficiencies synthetic hormones may help.

Vaccum devices : These involve using a manual hand pump to create a vaccum that pulls blood into the penis. To maintain the errection, you slip a tension ring around the base of your penis.

Surgery: Surgical options may be considered if other treatments fail. Various types of penile implants are available.

What you can do?

These steps may help decrease the likelihood of impotence:

1. Limit or avoid the use of alcohol and other similar drugs.
2.Stop Smoking.
3.Exercise Regulary.
4.Reduce Stress.
5.Get enough sleep.
6.Deal with anxiety or depression.
7.Communicate honestly and openly with your partner.
8.Consider seeking counselling as a couple.

Memberships

  • Urological society of India

    American Urological association

    European association of urology

    INTERPLAST, Germany.

     

    Field of Work

    All adult and paediatric urology operations
    Diversions
    Lower tract surgery
    Upper tract surgery
    Renal transplantation
    Percutaneous renal surgery
    Extracorporeal and intracorporeal
    Lithotripsy
    Use of CO2 laser
    Use of Holmium yag laser
    Flexible ureterorenoscopy
    Vascular access for dialysis
    Reconstructive urology
    Infertility
    Impotence