Erectile Dysfunction

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    Erectile Dysfunction

    Erectile dysfunction (ED) or impotence is the persistent inability to achieve or maintain an erection. A penile erection is a hydraulic effect of blood entering and being retained in a sponge-like apparatus within the penis. The process is most often initiated as a result of arousal when signals are transmitted from the brain to nerves in the penis.

    If erectile dysfunction only occurs occasionally, there is probably nothing to worry about, If it is a frequent occurrence, however, there may be an underlying medical cause. Many men with ED take medications prescribed by a physician such as Viagra and Cialis for many years and achieve unsatisfactory results. Lack of effectiveness associated with ED medications is usually the result of a blood flow problem either into the penis or out of the penis. The most common problem associated with blood flowing into the penis is an arterial blockage.

    Causes of Erectile Dysfunction

    Causes of Erectile Dysfunction

    While ED (Erectile Dysfunction) has many causes, the most important organic cause is an arterial blockage. Arterial blockage or Peripheral Arterial Disease (PAD) is a condition in which blood vessels in the pelvis that supply blood to the penis become narrowed due to atherosclerosis or a buildup of plaque. Atherosclerosis in the blood vessels supplying the penis prevents sufficient blood flow to the penis to sustain an erection. Atherosclerosis of the arteries supplying blood flow to the penis is strongly related to cardiovascular disease that causes arterial blockages in the heart, the blood vessels in the neck, or the blood vessels in the legs. Diabetes has a strong influence on the development of blockages of many arteries in the body including those which supply blood to the penis. Many combinations of medical and lifestyle influences can increase the likelihood of erectile dysfunction. Factors such as smoking, drinking alcohol, obesity, low HDL, and high blood pressure may also contribute to ED.

    Diagnosis of Erectile Dysfunction

    In our state-of-the-art vascular facility, we perform a thorough and complete vascular diagnostic workup for ED caused by an arterial blockage. In addition to a complete physical and history, we perform highly specialized ultrasound diagnostics to initially investigate the vasculature in the penis. The ultrasound exam is complemented by a highly specialized MRI examination of the blood vessels in the pelvis that is not performed at any other clinic treating ED in California.

    How We Treat Erectile Dysfunction

    If our extensive diagnostic testing reveals an obstruction of the blood flow into the penis, the next step is to perform angiography of the affected vessels and treat them to improve the blood flow.  Treating the artery bringing blood into the penis is like treating an arterial blockage in the heart or the legs. Angioplasty, for instance, is a very common tool to open blocked arteries. Most people associate angioplasty with treating heart disease, so they don’t realize that it is equally effective at improving blood flow to other organs and parts of the body that suffer from PAD.

    Erectile dysfunction treatment may also involve implanting a stent in a blood vessel supplying blood to the penis if the blockage is significant.  A stent is a small mesh tube that strengthens the arterial walls to open them up and prevent them from narrowing further. Stents are sometimes coated with medicines that help reduce plaque buildup.

    It’s important to note that treating the arteries supplying blood to the penis means treating a blood vessel in the pelvis, not a blood vessel in the penis itself.  This blood vessel is called the internal pudendal artery (IPA).  We treat the internal pudendal artery blockages using the same techniques we would use to open up blockages of the heart or the legs.  Modern minimally invasive vascular techniques allow us to restore blood flow to the penis in about 1 to 2 hours as an outpatient procedure.  After the procedure is finished, you will see a small band-aid at the top of one of your legs – this will be the only visual evidence that you had a procedure.  The process itself is almost completely pain-free and allows you to return to work typically within several days.  Our office will continue to follow up with you after your procedure to ensure proper healing and monitor your progress. We will also provide advice on lifestyle changes such as diet and exercise that can help you heal and keep you healthier in the long term.

    Is Poor Blood Flow the Cause of Your Erectile Dysfunction?

    If any one of the following is true you should consider contacting us to schedule a consultation:

    What to Expect from Your Visit to Pedes



    Your treatment will begin with an ultrasound examination of your veins, arteries, or both, in your legs to diagnose the presence and extent of the disease. Your test results will be immediately available to review with the doctor.