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What is Erectile Dysfunction?
Causes of Erectile Dysfunction 
Diagnostic Tests  
Treatment of  Erectile Dysfunctions
Impotence in Diabetics & Heart patients 
Sex Fitness Checkup


TREATMENT OF ERECTILE DYSFUNCTIONS

After diagnosing the cause of impotence of cause we prescribe medicines that patient has to purchase himself from any medical store The success of various drugs we use in erectile dysfunction depends on accurate diagnosis of cause. If empirical treatment is prescribed as most doctors do, it often does not achieves permanent cure. These sex tonics & ayurvedic medicines can improve your sexual life temporarily but they cannot give permanent cure. Thus please get yourself fully investigated before starting treatment. 
Response of Treatment: As we have fully dedicated team of highly qualified, experienced, doctors, sex counselors, sex therapist, who are expert in field of sexology. After finding the cause of erectile dysfunction by above tests it is cured in most patients by two months treatment.

The various treatment option for patient with impotence are:

1) Hormone Therapy
2) Medicines to increase blood supply to penis (Oral & Local Gels)
3) Viagra & like drugs
4) Sex Therapy 
5) Vacuum Erection Pumps 
6) Injection therapy
7) Penile Blood Supply increasing Surgery
8) Penile Hardness Increasing Implants (Penile prosthesis)

(1) Hormone Therapy:

Hormone therapy is given to cure the problem whatever defect is found.

Hormones Therapy: Depending on the type of hormone disorder i.e. whether male sex hormones decreased or inhibitory hormones has increased, Hormone therapy is directed towards that. Hormone therapy usually cures the Hormone problem in 2 to 3 months time and they do not have any adverse effects as they given to only those patients in whom some hormone disorder is found.
The various hormone preparations & their route of administration are: 
1. Oral testosterone preparations that is available in capsule form. It needs to be given one to three capsules daily. These have no side effects. 

2. Transdermal Testosterone given as scrotal patch. It is very effective & has no side effects. It can be also given as Testosterone gel, which can be applied on any part of the skin. 

3. Sublingual Testosterone cyclodextrin is now available which is very fast acting & very effective is fast & has better effects on sex organs. 

4. Local application of D.H.T. gel is new preparation for male hormone replacement. It is very effective without any side effects. 

5. Injection Testosterone esters these includes Testosterone enanthate & testosterone cypionate given intramuscular injections every 10 to 14 days. 
6. New human androgen receptor modulators they increase the effect of male hormone over androgens sensitive organs. 

7) DHEAS tablets are available which are effective & has no side effects.
8)Treatment of hyperprolactinemia with cabergoline & Bromocriptine is done with quick cure of sexual dysfunctions.

(3)Medicines to increase blood supply to penis: (oral & local gel)

Medical treatment (i.e. prescription of various drugs to increase blood supply to penis, nerve rejuvenating etc are given to correct the basic cause found on investigations.
These drugs open the blockade of penile arteries so that blood flows into penis increases and penis becomes fully hard. The various drugs, which are effective to increase penile blood supply, are as follows. The particular drug needed in particular patient depends on the cause of erectile dysfunctions.
Oral Drugs: The various oral drugs are: 

a. Yohimbine: By acting on alpha-receptors it dilates the penile blood supply. It is one of the common drug used for increasing penile blood supply. It is freely availalable as oral tablet. 
b. Phentolamine: is also a good drug to increase blood flow in the penis. The effect of this drug increases manifold when it is used along with other commonly used vasodilators. It is used as oral, sublingual tablets. In advance cases it is given as injectable also. 
c. Sublingual apomorphine is very effective in increasing penile blood supply. 
d. Trazadon works on sex centre & increase penile blood supply.
e Oral Prostaglandin. 

f Nalaxone
g Gene Therapy: In this modality of treatment blood supply to penis is increased by gene therapy. By the introduction new genes in body the generation of penile blood increasing substance nitric oxide generation increases in penile blood tissue leading to more blood supply & hardness of penis. This is a slow process takes longer time to have effect but once the effect starts coming the results are permanent. Thus it achieves the cure of impotence. This is effective & achieves permanent cure of impotence

3) Local Application of Gels / Drugs

a. MUSE is per urethral use of PGE1. In this medicated pellet is inserted into the Urethra. After insertion penis becomes hard with in 20 minutes. This hardness lasts for up to 60 minutes. 
b. Topical preparations of papaverine 
c. Topical preparations of prostaglandin E1 
d. Vasoactive intestinal peptide
e. Local application of Minoxidil
f. Local application of Nitroglycerine
g. Local application of l-arginic acid

(3) Viagra & Like drugs

These drugs are good but temporary method of treatment because it does not treats the basic cause of sex problem. These drugs belong to following the groups:

Sildenafil,( Viagra, penegra, caverta) : one tablet works for 4 hours.

Tadalafil (Cialis, tadalis, megalis ) : one tablet works for 24 hours.

Vardenafil (Levitra): one tablet works for 6 hours. 

It is a temporary therapy. After consumption of this tablet, patient gets hardness only temporarily. Once this tablet is consumed, the blood flow into penis increases & penis becomes fully hard in many patients. But this is an effective short-term treatment but it does not cures the basic problem. It also has certain side effects & many deaths have been reported after its use if not used with proper precaution. Thus it should not be consumed without the advise of experts. There need to have detailed physical examination before one is prescribed Viagra. So never take it without expert advise.
Dose used is 25 mg to maximum of 100mg. It should be taken 60 minutes before sexual intercourse.
5. Detailed Sex Education: In this patient is explained in detail about what is normal physiology of erection and what we can do in our daily life to increase erectile strength & staying it hard for longer time. Also we educate the patient how to satisfy the women so that she gets satisfactory orgasm and considers you a wonderful partner.

(4) Sex Therapy: 

Once we found out the cause we treat internal causes like hormone disorder & decrease penile blood supply. But even after treating above basic primary causes of impotence, Many times patients still do not recovers fully because of his fear of failure, sexual performance anxiety and spectatoring attitude. These secondary factors do not allow him to function normally. For cure of these secondary problem patient needs details sex therapy. Basic purpose of this exercise is to make patient free of any fear of sexual performance. After this exercises all performance anxiety disappears. In sex therapy the patient is taught various exercises & how to use various body part in particular way so that erection become good, sustained & patient does not have any fear. Normally in six to eight sittings patient's all fear disappears. Sex therapy is a very effective in impotence, premature ejaculation. Thus we advise all of our patients not to hurry, and take few sessions of sex therapy sittings for permanent cure.

(5) Vacuum Pump Devices 

Vacuum Pump Devices is a small instrument, application of it on penis, makes penis fully hard within three minutes. With this instrument patient does not have to consume any medicine. So it has no side effect.
(By this device a vacuum of > 100 mm of Hg is created around penis leading to Pooling of blood in penis resulting in full hardness).
Efficacy: Approximately 80% of patients get full erection & satisfied. 

(6) Injection Therapy

The various drugs used as injections are 
Injection of papaverine, ProstaglandinE1, & Phentolamine is used alone or in combination (bimix or trimix). This is a very effective mode of treatment of impotence. The dose of papaverine is 5mg. to 60mg. at one time. It work in 15 minutes & patient gets very hard erection, which lasts for at least thirty minutes. It is very good especially for those who fear that they may fail during sex. So that by taking this injection they can perform without fear & with hundred percent guarantee of success. It is a quiet popular form of treatment among boys & young adults. Especially for those, who have severe fear for failure for the first night or when expecting sexual encounter with a new partner. 
Response - Success is achieved in approximately 90% patients. 
Injection of ProstaglandinE1: dose used is 10 to 20 mg at one time .It is very effective with virtually no side effects.
Injection of Phentolamine normally it is used in combination with papaverine or Phentolamine.
Inj. Of Moxisylyte: available by the name of injection Erecnos.
Inj. of Vasoactive Intestinal Polypeptide: available by the name of injection Invicorp.

Treatment of underlying cause: When some underlying cause as diabetics, depression, high blood pressure (hypertension), or use of drug is diagnosed is treated accordingly. 

Future Treatments for Erectile Dysfunction
Topiglan
Avanafil
Melanocortin Activators
Gene Therapy
 

Surgical Treatment 

Surgical treatment is suggested only when all the above mode of therapy namely hormone therapy, blood supply increasing tablets, Viagra like drugs, & sex therapy has failed.

(7) Penile blood supply increasing surgery:

After investigations when it is diagnosed that blood supply is decreased. In majority of patient's blood supply can be normalized by many of the medicines as mentioned above, which have capacity to correct the vascular disorders. But in some cases surgery is required.
Before surgery for vascculogenic impotence, exact site of blockade is localized by Arteriography.
The various surgeries are as follows: 
a) Arterial Recanalization surgery: After localizing the block, we open the blocked part of artery by vascular microsurgery, this is called recanalization vascular surgery. This is commonly done in younger patients.
b) Arterial bypass surgery: When we find that there is blockade in broad segment of dorsal penile artery then such a long segment can not be recanalized. In such cases we bypass the blocked portion of the artery by use of other inferior epigastric artery. In this normal artery is connected with penis artery distal to blocked artery so that blood flow normalizes.
c) Venous leak surgery: As we have mentioned above leakage of blood from penis to back into body in mid of erection is one of the cause of impotence. In this surgery the leaking veins is localized first by venography (cavernasometry & cavernosography). After localization of those veins through which blood is leaking are ligated i.e. tied. Thus venous leak stops & penis starts becoming full rock like hard & patient sexual problem normalizes. For this surgery we keep patient admitted for one day only. 
At our centre our micro vascular surgeon is very expert in doing all above surgeries. In this surgery artery in which blockade is present is either opened or blocked area is bypassed by use of other artery so that blood Supply to penis is established. Result is very good when candidate for surgery is properly selected. This operation needs expertise. It is done under the guidance of operating microscopes. 

(8) Penile Hardness Increasing Implants (Penile prosthesis): 

There are some patients in whom blood supply increasing surgery is not possible. Thus penile implant is a good treatment in all those patients in whom cure is not possible inspite of all above treatments. In such cases we put intrapenile implants. After these surgery patient can resume his normal sexual functions.
There are two kinds of implants:
a) Malleable i.e. semi rigid implants:
b) Inflatable implants: Now days this implant is more in use as penile hardness is very good above all it may remain erect for longer time. This surgery takes approximately 30 minute by our surgeon. 

There are certain penile implants which when applied into penis then its hardness become very hard. 

Thus my advise to any body who is suffering with erectile disorder: 

1) Please get yourself completely investigated, find out the cause, get complete treatment accordingly with good cure rate. 

2) Never presume your problem as Psychogenic unless other causes have been excluded. 

3) Remember males should be potent till late seventies unless they have some cause such as Hormone disorder or decreased penile blood supply. So at any age you may attain potency after complete diagnosis and treatment. 

4) Remember Ayurvedic doctors do not have knowledge of various causes of erectile dysfunction and they just give empirical sex tonics with no improvement or only partial temporary improvement. Also unfortunately most Ayurvedic doctor exploit patients. 

5) Now treatment of impotence is possible with satisfactory results with the availability of newer drugs.

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|| What is Erectile Dysfunction? || Causes of Erectile Dysfunction || Diagnostic Tests ||
||
Treatment of Erectile Dysfunctions || Impotence in Diabetics & Heart patients || Sex Fitness Checkup ||


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We get patients from all major cities in India & Abroad . In the following cities all the facilities for investigation & treatments including medicines are available as Delhi (North, South, East, Central, West, New Delhi). To Different Communities like Hindustani, Hindustan, Hindu, Christian, Muslim, Sikh, Parsee. The other cities are NCR, National Capital Reagion in India, Indian, Hindustan, Ghaziabad, Faridabad, Noida, Gurgaon Gurugram, Meerut, Bombay, Chandigarh, Calcutta,  Simla, Jammu, Srinagar, Aligarh, Lucknow, Kanpur, Allahabad, Varanasi, Dehradun, Madras, Kolkatta, Nainital, Agra,  Jaipur, Bikaner, Jodhpur, Porbandar, Dwarka, Ahmedabad, Gandhi Nagar, Vadodara, Surat, Mumbai, Pune, Thane, Panaji, Nasik, Nagpur, Indore, Ujjain, Bhopal, Gwalior, Jabalpur,  Raipur, Hyderabad, Goa, Visakhapatnam, Bangalore, Banglore, Bangalooru, Mysore, Mangalore, Manipal, Chennai, Pondicherry, Madurai, Kanchipuram, Coimbatore, Kanyakumari, Ernakulam, Trivandrum, Darjeeling, Gangtok, Bhubaneswar, Puri, Guwahati, Shillong, Imphal, Kohima, Agartala, Patna, Ranchi.

 

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