Other Treatments
Medical treatment of the erectile dysfunction generally consists of one or all of the following: taking the patient history, physical examination, and appropriate medications. A good history and physical examination are paramount to help determine the cause of the impotence. Should a treatable condition be found, appropriate medications or changing medications would be in order. Sometimes a specific cause is not found, even when the patient continues to manifest organic or physical impotence. In those cases one or several of the following therapies may be tried.
Initial treatment of the condition may consist of using a mild vasodilator such as Yohimbine in an effort to improve penile blood flow. It is important to remember that this is not specific for the blood vessels of the penis and there may be side effects associated with its use, such as dry mouth, dizziness, and upset stomach. This medication has about a 30 percent objective response rate.
Those who may not be able to tolerate Yohimbine or fail to respond to it may need to consider a vacuum system. There are approximately ten manufacturers of various vacuum systems. All the vacuum systems work in basically the same way. They create a negative pressure around the penis and literally draw blood into the penis until the penis becomes very tumescent. At this point the individual places a rubber ring or rubber band around the base of the penis, trapping the blood in the penis and providing an erection lasting for up to thirty minutes. Then the rubber band is removed. Patients who are taking anticoagulants or have local skin diseases in the genital region, which may worsen with use of this suction device, should not use the vacuum system.
Another treatment that is becoming increasingly popular is penile injections. Medications that have been included in this form of therapy are papaverine, phentolamine (Regjtine), and prostaglandin (Caverject). Of these drugs, only Caverject is approved by the Food and Drug Administration for use in the treatment of impotence. The individual learns to inject a measured amount of drug into the corpora cavernosum within the shaft of the penis, which produces a very prompt erection lasting on the average between thirty and ninety minutes. This drug has proved to be safe and reliable in approximately 70 to 75 percent of men. Contraindications to the use of penile injections include concurrent anticoagulant therapy or existing scarring of the penis such as Peyronie’s plaque. Long-term effects can include scarring, which may result in an irregular curvature of the penis. If this should develop, it is advisable to immediately discontinue penile injection therapy.
The most definitive treatment to date is penile implantation. There are basically three types of penile implants: a pair of malleable rods, a self-contained pair of inflatable prosthetic cylinders, and a three-piece fully inflatable prosthesis. These prosthetic devices must be surgically implanted. Two of the most common complications consist of infection or mechanical failure. Both occur less than 5 percent of the time. If infection should occur, the device would have to be removed and at a later date, a second device could be implanted. Infections are slightly more common in diabetic men. If the device fails, a re-operation is required to correct the defect and/or repair part or all of the prosthesis. Nevertheless, sexual satisfaction rates on the order of 90 to 95 percent for both men and women are quite common with penile implantation.
Penile re-vascularization has failed to provide satisfactory return of potency in the majority of men. It has been used in individuals who have rather discreet localized arterial blockages or in those individuals who may suffer from significant venous incompetence. In this operation, the penis is re-vascularized with a neighboring blood vessel, such as the inferior epigastric artery, which is located in the lower abdomen. Basically the artery is retunneled into the penis to provide new blood flow. In case of venous incompetence, the large dilated veins that drain the penis are literally tied off or ligated.
A rate of cure of impotence of 50 to 75 percent is reported by secular therapists. I have no exact statistics to quote, but I have observed a rate of cure that is much higher for the Christian husband who claims and uses his extra resource against the main villain—fear of failure. God has given us resources far greater than the spirit of fear, and resting in that knowledge will provide the Christian husband with a stability and relaxation that can go far in solving almost every impotency problem. The Bible says, “For God hath not given us the spirit of fear; but of power, and of love, and of a sound mind”.
Every situation of life in which we see our own inadequacy can be an opportunity to see the power of Christ undertaken for us. No need is too small or too great for our God to meet, we discover, as we count on Him!
Posted in For the Impotent Husband
To Ed Wheat Sr. and Gladys Gibson Wheat, whose commitment, devotion, warmth, generosity, and integrity stood for fifty years as a beautiful picture of genuine agape love.