More than half of the 50 or more years of age who have diabetes, experience a certain degree of erectile dysfunction.Unfortunately, very few of them consult the doctor for this problem.But if they do, there are many chances that the treatment is effective
Erectile dysfunction, also (badly) called impotence, refers to the inability to achieve or maintain enough erection for sexual relationship with penetration or intercourse.Erectile dysfunction can be the result of physical or psychological factors.In men with diabetes the most common causes are the physical problems derived from the bad control of the blood sugar level, the long -term complications of the disease and, often, of the unwanted side effects of some medications.
Too high levels of blood sugar, or blood glucose are able to injure nerves and blood vessels responsible for erections.When the nerves are injured, they cease to be able to communicate with the small blood vessels of the penis, to allow them to dilate and accommodate the blood flow necessary for an erection.When the large blood vessels narrow or blocked, enough blood does not reach the penis to produce an erection.
The main psychological factors that can produce erectile dysfunction are anxiety, stress and depression.They can interfere with the normal production of hormones of the organism and the way in which the brain responds to them, preventing erection.To some men, the simple audition of "problems with erection associated with diabetes", they produce such fear of the disease, which is precisely the cause of finally appearing.
Some medications can also cause erectile dysfunction, including medications for the treatment of arterial hypertension, anxiety and depression.If a man with diabetes is experiencing erectile dysfunction, the first thing to review is the medication you are taking.
There are several therapies currently available for the treatment of erectile dysfunction.They may not be able to definitely reverse or cure the problem, but they can make it possible to maintain satisfactory sexual relations, both for the patient and for the couple.
medications
Often, the first step for effective treatment of erectile dysfunction is the use of medication:
Sildenafil .In many men with erectile dysfunction as a result of their diabetes, sildenafil (viagraâ) can improve sexual function, although it is not effective throughout the world.Unlike other treatments for erectile dysfunction, sildenafil produces a natural erection instead of an artificial.This drug helps to respond to sexual or psychological stimulation through the relaxation of smooth muscle tissue, which in turn increases blood flow in the penis and makes it easier to reach and maintain an erection.To do this, it is enough to take the blue tablet shaped like a diamond, about an hour before the sexual relationship.The drug is effective for about 4 hours and should not be used more than once a day.
Sildenafil, however, is not safe for all men.This drug should not be taken if nitrates are being taken, for example nitroglycerin.Taken together, the mixture can make blood pressure down and produce fatal cardiac complications.Sildenafil can also produce other side effects, such as facial hot flashes, which in general do not last more than 5-10 minutes.You can also experience a mild and passenger headache or a certain gastric discomfort.High doses can produce short -term visual problems, such as a bluish coloration ofobjects, blurred vision and increased light sensitivity.These effects disappear a few hours after taking the drug.
alprostadilo .Alprostadyl (caverjectâ, museâ) is a synthetic version of the E-1 prostagland hormone.Like sildenafil, this medication helps relax smooth muscle tissue, facilitating blood flow and producing an erection.Occasionally, alprostel is combined with other vasodilators medications to increase its effect.Alprostadilo is not a pill, but must be administered intraureterly or by injection.
Intraurethral self-administration.For intraurethral self-administration, the patient himself placed an elastic rubber around the penis base and introduced by the hole of the tip of the penis a disposable applicator to insert a small suppository, of a size as a half grain of rice,inside the urethra.The suppository is absorbed by the erectile tissue of the penis, increasing blood flow and producing an erection.Among its unesible side effects are the production of pain, dizziness and the formation of fibrous and hard tissue.
Self-injection.For self-injection, a fine needle is used to inject the alprostedyl based on the basis of the penis, which increases blood flow in the peak-type structures and an erection occurs.The drug takes to act 5 to 20 minutes and the erection it produces is maintained around an hour.Thanks to the needle is as fine, as those used to inject insulin, the pain produced by injection is normally minimal.Among its side effects are bleeding in the place of injection and rarely, a prolonged and painful erection, called priapism.To minimize the risk of prolonged erection, it is important to prove the medication to determine the appropriate dose.If the erection lasts more than 4 hours, the blood trapped inside the penis becomes thicker because of oxygen loss.This can injure the penis tissue.Another rare side effect is the formation of a fibrous nodule in the injection site.This method can also cause bruises if by accident a small blood vessel is clicking with the needle.
Research in new pharmacological treatments of erectile dysfunction has obtained good results and will soon be available, if they are not already, recent therapeutic alternatives.
Vacuum instruments
Some men use vacuum creative instruments when medication is not effective or their side effects are too annoying.These instruments use the absorbent pressure of the vacuum to get blood to the penis.First the penis is placed inside a plastic tube and by means of a manual pump, the air outside the plastic tube is expelled.When doing this, blood is made into the erectile tissue of the penis producing a strong erection.Then a rubber ring travels that is located at the base of the plastic tube and placed around the penis base.This ring catches the blood inside the penis, allowing the erection to be maintained once the tube penis has been extracted.You have to remove this ring before 30 minutes to restore the normal flow of blood from the penis;If this is not done, the penis tissue can be injured.A vacuum pump is effective in more than 90% of men who use it and do not require medication or surgery.
Penis implants
If medications and vacuum instruments have already been tested and have not been effective or are uncomfortable, the option of surgical implant can be considered.There are three types of implants:
· Semi -rigid, with two flexible rods.The implantWith flexible rods it is the easiest to use and the one that is less likely to bad functional.Two hard but flexible rods made of metal and coated with silicone or polyurethane are inserted inside the penis.They provide permanent erection.He manually adjusts the penis down and to the leg to hide the erection and up to maintain a sexual relationship.While it looks unnatural and takes a bit to manipulate it correctly, this implant requires less surgical time than other implants, it has no mechanical parts that can be found and has a high success rate.
· Inflatable.These implants provide a more natural aspect than the semi -rigid cylinders.Instead of producing a permanent erection, the patient himself produces an erection when he wants to have it.
or a version is composed of two hollow cylinders that are placed inside the penis.These cylinders are connected to a small pump that is placed in the scrotum, and to a deposit that is placed in the scrotum or in the lower area of the abdomen.When the pump is tightened, the liquid of the tank fills the cylinders and the erection occurs.This implant is easily hidden and very effective, but is more likely than other implants of mechanical breakdowns.
or another version does not incorporate a pump.Instead, an instrument that is placed near the head of the penis controls the flow of liquid into the cylinders.To obtain an erection, it is enough to tighten the head of the penis.This releases liquid inside the cylinders.To return the liquid to its place and return sagging to the penis, the implant is flexed and a release valve is pressed.
· Overlapping blocks.This type of implant is similar to the semi -rigid implant, except that it is formed by a series of small blocks connected by a fine steel cable.It is easy to use, easy to hide and produce an erection only when you want.
Author: Dr. Salvador Giménez - March 13, 2003
