Medsarticles. Medical Weblog

Here’s what to expect from the semirigid implant surgery. To avoid infection, some doctors ask patients to shower with a special antiseptic soap for several days before the operation. This procedure helps to decrease surface bacteria and may reduce the chance of infection. For the same reason, some doctors put patients on antibiotics for a period before and after the operation.

Although infections with prostheses are rare, caution is in order, because anytime you have a wound with a foreign body in it, like a penile implant, it takes fewer bacteria to cause an infection than in a simple incision without a foreign body,

With semirigid implant surgery, you might have a general, local or spinal anesthetic, depending on your general health and the preferences of your doctor. In any case, you won’t experience pain during the procedure, although with a local anesthetic you might feel some pulling and pressure.

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Your doctor should ask detailed questions about the specifics of your problem. He’ll want to know when your problem started, how long it’s been going on, if it’s always present or sometimes not. He may ask you to photograph your erection, so he can get an idea of how it looks. He’ll want to know if you get erections when you masturbate or when you wake up, and if so, what the erections are like.

It’s relatively rare, but sometimes a man finds himself with a penis in which one part is erect and another is not. The shaft of the penis may be erect, but the tip is flaccid. The penis may also curve to one side when erect. Such specific descriptions will help your doctor focus on the possible causes of your potency problem.

Be sure to tell the doctor about any circumstances in which you can obtain a full, firm erection. A man with the “pelvic steal” syndrome may be able to maintain an erection if he lies on his back and is less active during intercourse than if he is on top of his partner. A man with this syndrome has diseased arteries. When he’s very active, the muscles in his legs and buttocks rob the blood from his penis, leaving it flaccid.

How you feel emotionally is also an essential part of your story. How is the situation affecting your life? How do you feel about yourself?

How your partner is handling the situation is another crucial piece of information. A supportive, involved partner can be immeasurably helpful in treatment and make a successful outcome more likely—and pleasurable. On the other hand, a hostile partner can make successful treatment difficult or impossible. Remember that many women feel they are somehow to blame for the situation, and need a lot of reassurance and support. You can help your partner and yourself by keeping her involved and informed whenever possible.

If your relationship is on the rocks and you can’t seem to get back on the right track, we recommend you and your partner seek help either before you resolve your potency problem or at the same time you are undergoing treatment. Simply curing your potency difficulty will not, by itself, heal a damaged relationship.

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It’s important not to let the situation fester for a long time without talking about it. Be honest and up-front about how difficult it is for you to discuss it—and then start talking. The longer you wait, the more opportunity there will be for bad feelings to develop.

This happened to Walt, a field supervisor for a large private utility, and Becky, his wife of 20 years, who ran her own crafts business. They were a happy couple with three children in high school. Walt, a muscular, physically-fit man spent his free time on family activities and kept his small farm running smoothly. Sex was very important to him, and he took pride in the fact that he and his wife had an active, satisfying sexual relationship. Walt was the kind of man who never was sick, but after his

42nd birthday he developed a severe infection in his bladder. Excruciating pain forced him to go to the doctor, but the infection proved stubborn and remarkably resistant to treatment. In rare cases, such a condition can infect a testicle, and that’s what happened to Walt. Although he was given an antibiotic that ultimately cleared up the bladder infection, the infected testicle could not be saved and had to be surgically removed.

The removal of just one testicle does not affect a man’s ability to have an erection, or reduce his chances of fathering a child. The other testicle simply picks up the testosterone-producing and sperm-manufacturing functions of the missing organ.

But for Walt, who took such pride in the appearance of his body, losing one testicle was an enormous shock. Physically, he recovered from the operation, but he was beset with anxiety and fear. Walt felt that a vital and essential part of himself was missing. For the first time in his life, this man began to have trouble maintaining an erection. When Walt started to have intercourse, his erection would disappear.

Becky was totally unprepared for this turn of events. Sometimes she became very disappointed when Walt lost his erection while she was sexually aroused. She didn’t understand the reasons for the sudden change in her husband (neither did he), and sometimes she became angry.

Even now, several years later, Walt becomes upset when he remembers what happened. “My erections went away overnight.” He became more and more troubled and increasingly fearful of trying to have intercourse.

This was an enormous and painful change for Walt and Becky, who considered sex a major and important part of their relationship. But even though the problem continued, they didn’t talk about it. Instead, Walt put his energies into avoiding sex— and his wife. He put in long hours at work, and when he was home became extremely creative in finding reasons to stay away from Becky. “I didn’t want to start anything I couldn’t finish,” he says,

It seems clear from Walt’s story that his erection problem was psychological, not physical. When his anxieties about the loss of his testicle first surfaced, he could have been helped by some intensive, short-term counseling aimed at reassuring him that he was just as capable of having an erection as he ever had been. Perhaps Walt needed to mourn the loss of a part of his body that was important to him. He also could have had his missing testicle replaced by a lifelike artificial one which would have given him the appearance he valued so highly.

But unfortunately, Walt did not seek out and did not receive help. And neither did Becky. In fact, they went for three years without consulting anyone. That’s a long time to go without sex, and Becky and Walt were living together without physical affection of any kind, without much warmth or tenderness and with limited communication.

Going into the fourth year of the problem, Walt finally mentioned it to his family doctor. By then, however, the damage to the marriage was irreparable. Although Walt ultimately was able to regain his potency, he and Becky separated.

Even now it is difficult for Walt to talk about his experience. “My wife is a good woman,” he says with apparent pain. “But she couldn’t put up with my problems. If I had to do it over again, I’d get help sooner,” That’s good advice from someone who knows.

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In fact, it’s estimated that a million and a half American men can blame their erection problems on arteries and veins that don’t work properly. In one autopsy study, all men over age 38 had some narrowing of the arteries to the penis. Fortunately, however, that can largely be prevented with a healthy diet, proper exercise and general good health habits. (A small number of arterial-blockage cases occur when a man suffers a major trauma, such as an accident.) Some relatively rare diseases, like lupus, which affect the arterial system as well as other parts of the body, can also short-circuit erections by interfering with the blood-flow system.

Despite what you may have heard, even young men can have arterial disease, although it may take years before the damage presents itself in the form of erection problems or heart attacks. If you do develop blockage in the arteries supplying the penis, help is available. Usually, an implant will be the treatment of choice, but some patients can benefit from having a surgical bypass of the penile arteries.

Arteries, though, are only half the story—the way the blood enters the penis. But the blood has to stay there for you to be potent. For that you need healthy veins.

For years, doctors thought only malfunctioning arteries deserved the blame for blood-flow problems in the penis, but now doctors have found that many men suffering erection problems can place the blame on their veins. Why?

When a man’s penis is flaccid, the veins keep the blood flowing out of the organ as part of the normal blood circulation. But during erection, the veins, squeezed by the blood-filled sinuses, must shut down partially to keep blood in the penis so it will stay firm and erect. If the veins don’t shut down as they’re supposed to, a man will experience a disheartening situation. He may get no erection at all; he may find himself with an erection which just never gets really firm or he may get an erection that disappears before he and his partner have a chance to enjoy it. What causes this discouraging condition? Apparently, some men are born with leaky veins; their veins never or almost never function properly.

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