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Erectile dysfunction doesn't have to be a problem! Dr Kent DeLay can help you fix it!

If you're having trouble getting or maintaining an erection, you may be suffering from erectile dysfunction. Learn more about this condition and how you can treat it by reading this article.

Erectile dysfunction

Erectile dysfunction (ED) is the inability to get or keep an erection. It can be caused by health problems, emotional or relationship difficulties, or certain medications.

There are many potential causes of ED, and often more than one. That’s why it’s important to work with a healthcare provider to figure out the cause, or causes, of your ED.

ED can be caused by:

  • Health problems, such as heart disease, high blood pressure, diabetes, and obesity
  • Injury to the nerves that control erection
  • Certain medications
  • Tobacco use
  • Alcoholism and other forms of substance abuse
  • Emotional or relationship difficulties

In many cases, ED is caused by a combination of these factors.

How is ED diagnosed?

Your healthcare provider will ask about your symptoms and health history. He or she will give you a physical exam and may order tests, such as blood tests. These tests can help find health conditions that may be causing your ED.

How is ED treated?

The treatment for ED will depend on what is causing it.

In some cases, medications may be used. These include:

  • Oral medications, such as sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra, Staxyn)
  • Intraurethral medications, such as alprostadil (Muse)
  • Injections into the penis, such as alprostadil (Caverject Impulse, Edex)
  • Penis pumps, such as the vacuum device

In some cases, surgery may be needed.

Your healthcare provider may also suggest lifestyle changes, such as:

  • Quitting smoking
  • Losing weight
  • Exercising more
  • Eating a healthier diet
  • Reducing stress

If you have diabetes, tightly controlling your blood sugar level can help.

What are the risks of ED?

ED is not a life-threatening condition. But it can affect your quality of life. It can also affect your relationships.

If you have ED, you may:

  • Feel embarrassed or have low self-esteem
  • Have trouble with your partner
  • Feel anxious or depressed
  • </ul
I talk through the basics of:

What is ED?

What causes it?

How do we treat it?

To make an appointment call 803-739-3660




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Video transcription:

So I’m dr kent delay you’re, probably watching this presentation, because you have an upcoming appointment with me to discuss ed or erectile dysfunction. So I just want to give you a bit of information so that we can discuss your particular situation and have some background about the situation. So what is erectile dysfunction? So it’s simply the consistent inability either to get an erection, that’s firm enough for intercourse or to keep an erection firm enough for intercourse. So some men will get an erection that is initially good enough, but then lose it and some men never get an erection firm enough to penetrate to start with. So both of these things are erectile dysfunction or ed. So, if you’re seeing me for this, I want to emphasize how common erectile dysfunction is so 30 million american men at least more than one in four men in their lifetime, will have ed at some point. So while this isn’t a normal part of aging, it’s really common folks, don’t talk about it. So it’s easy to feel embarrassed, but it is very, very common and nothing to feel embarrassed about it’s a medical condition just like any other. So we used to believe that erectile dysfunction or the inability to keep an erection within your head. This wasn’t a physical disease. It was more of a mental condition, but now we know that’s absolutely not true. So ed is a vascular issue in most men, so the blood vessels simply don’t open up well enough for the man to have enough blood to get an erection once we kind of diagnose that problem, we’re able to go through the treatment options and get the vast majority of men better. So while vascular issues from either diabetes or heart, disease or cholesterol or high blood pressure, the most common there are other physical causes as well: men who have had some type of injury to their nervous system, whether it be brain or spinal cord. We talked about diabetes and heart disease already, if you’ve had an operation or radiation to address prostate cancer, that can be an issue and some drugs and medications also cause ed. So aging, as we said, is something that is very commonly associated with ed, meaning that the older you are the more likely you are to have erectile dysfunction, and there are a number of reasons for that. Probably the biggest is that, as we get older, we’re more likely to develop other medical conditions that cause ed, but nonetheless, as we get older, more and more men are going to experience this problem, so diabetes and high blood pressure are two of the biggies that cause ed and don’t want to go into a lot of detail here. But the bottom line is both of these. Diseases are hard on our blood vessels and we need good, healthy blood vessels to get an erection once again, as we age more likely to get other diseases, that’s more likely to cause erectile dysfunction. So how do you get a normal erection? So this is really important to understand how this works, so we obviously have to get sexually stimulated initially, and that happens on our brain. The brain sends signals with through nerves that go to the penis, and this causes an increase in blood flow, and so we need our heart to pump well, our blood vessels to open and our hormones to facilitate all of this to get a rapid increase in the amount of blood going to our penis. When this happens, the blood causes the penis to fill out or what we call engorge when this happens, the veins that drain our penis stop having outflow so meaning the blood is trapped in the two spongy chambers that cause an erection and the the end result is more blood in less blood coming out and you get a firm erection that allows you to penetrate force. So that’s how a normal erection happens. So if that process breaks down, what are our treatment options and most men will at some point in their lives, try some type of pill for erectile dysfunction. The most common three are Viagra Cialis and levitra. Viagra was the first one to come out in 1998, and these pills work to increase blood flow to the penis, but they’re, not an automatic erection. So these require that we get mentally and physically stimulated, and in conjunction with that that causes more blood to come into the penis. These are very safe medications by lar. By and large, there are a few side effects that men will complain of headaches, flushing some gi upset, particularly with Viagra and levitra. You could have some visual changes that are temporary and particularly with Cialis. You can get some back pain or muscle aches and all of these go away once you stop the medication, but unfortunately, if you have these side effects, you’re more likely to have them every time you take the medication. So if that doesn’t work, there’s what we call penile injection therapy, just what it sounds like and just what the picture shows. You take medication that you inject into the penis. This causes an increase in blood flow causes, an erection. This doesn’t require as much mental and physical stimulation since you’re immediately putting a medication into the penis that causes more blood flow. There’s some men who do great with this and do this for years, there’s some men who can never even get up the nerve to try. It for the first time- and there are a lot of guys that are in between that will do it for a while, then decide that it just isn’t for them overall, quite safe things that can happen. Is you can’t get an erection that lasts too long? If you overshoot the dose so we’re pretty careful with that, you can get some bruising and pain where you put the needle in obviously sometimes with particularly with repeated injections. You can cause scar tissue to build up in the penis and get curvature or something we call peyronie’s disease like I said there are guys who do this for many many years, and then there are guys who say hey. I don’t want to stick myself to get an erection for the rest of my life and for those patients, they’ll mainly move on to a penile implant and we’ll get to that momentarily. There are vacu devices, essentially a penis pump. The way these work you put them in the outside of the penis. You create a suction that brings blood into the penis. I don’t really have any patients who use these long term and the reason they’re kind of cumbersome the patient’s telling me that the blood that comes into the penis kind of feels cool to the touch. So it feels unnatural and just most patients aren’t going to do this long term. I’ve mentioned this just for completeness sake. There are urethral suppositories that you can put in the end of the penis or at the urethral opening they’re absorbed and are intended to cause an erection two problems with these one. It hurts a lot of burning where you put it in and two they just really don’t work that much better than the pills they’re quite expensive, and so I don’t have anybody on these in my practice right now. So, finally, there is a penile implant. Now there are two versions of this: one is called a malleable and the other one’s an inflatable won’t go into a lot of detail again here, but for the vast majority of men who want a penile implant and inflatable is the device that you’re going to end up getting and the way it works, and you can see on the schematic. Is you have a pump that sits in between the testicles and this is all below the skin? You have two cylinders that go into the penis one on each side that creates the erection, and then you have a reservoir, which is a container that holds the fluid that sits right above the bladder. So the first thing folks see or think when they see this is oh. This is a lot of stuff must be a really big operation. Actually, there are two places we can make the incision one’s right above the penis and one is where the penis meets the scrot. Usually the incision is a couple of centimeters, so not particularly big, so we can put a lot of stuff in through a fairly small incision. The other thing, folks think is: oh wow. People are going to be able to tell I have this. Like I said it’s all below the skin, and when you are healed you could walk naked through a locker room nobody’s going to know you have a penile implant so the wa y it works when you want to have an erection, is you will squeeze that pump that sits in between your testicles? It will transfer fluid into the device, so the cylinders are like water balloons and the more fluid you put in them, the firmer they get, and this causes an erection when you’re done, you hit a deflate button on the pump, the fluid transfers back out and you’re natural again so once again, all below the body or I’ll blow the skin. Rather once you’re deflated it’s going to hang natural you’ll. Look like your normal self. It feels like a natural erection, so you might think. Oh, this wouldn’t feel right or would feel weird. But people actually tell me it feels more natural than the injections for a lot of folks. It will expand the girth of the penis, but the device will not make you any longer or shorter than you already are, and people really like these and they work very well. So what are some of the issues? So I think people often assume that oh, this must be cosmetic and my insurance won’t pay for it. No, this is a medical device for a medical condition, erectile dysfunction, so most insurance plans cover the procedure. If you have medicare in a secondary, you really essentially have no out-of-pocket cost with the procedure. Different commercial insurance plans, so blue cross cigna aetna have different rules state by state, but we can work with your insurance company and find out what would be the case for you whether you would have out-of-pocket cost and work through that process. We are working on making sure that if insurance doesn’t cover, we can get our cash prices reasonable and that’s something that we could discuss as well, but look forward to seeing you at your visit and discussing any questions you may have.

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