Penoscrotal Conditions Overview
With the exception of testis cancer, most conditions of the penis and scrotum are benign although they can still be very bothersome. Listed below are some of the more common conditions:
Erectile dysfunction is the inability to obtain or maintain an erection for satisfactory sexual activity. Treatment is usually based on a stepwise ladder of options listed below.
Healthy lifestyle and weight loss
The commonest cause for erectile dysfunction is injury to the arteries that supply blood to the penis. In the same way that a healthy lifestyle protects from heart disease, the same advice applies to erectile dysfunction. Control of cardiovascular risk factors involves a heart healthy diet and lifestyle to keep weight to a normal BMI, control of cholesterol, diabetes and hypertension.
Viagra-like oral agents (Phosphodiesterise-5 inhibitors)
Viagra (sildenafil) and similar medications such as Cialis (tadalafil) and Levitra (vardenafil) temporarily increase the blood supply to the penis by relaxing the muscles in the arteries, allowing more blood flow. They are usually taken an hour prior to sexual activity. They cannot be taken with nitrates which are used to treat angina. Common side effects include headaches, nasal congestion, temporary vision colour changes in blue and green, nausea and gastric reflux. It usually takes a number of attempts before knowing whether these medications work.
Vacuum pump and construction ring
A vacuum pump is applied to the penis so that the blood is “sucked” in to give an artificial erection. A constriction ring is placed at the base of the penis once an adequate erection is achieved to keep the blood in the penis. This treatment works for most causes of erectile dysfunction and is medication free. Some problems include a slightly cold and blue erection.
In this situation, medication is directly injected into the penis to produce an erection. Education on the technique is provided in the office and a test dose is usually given so that the correct dose is prescribed.