Erectile Dysfunction

IT’S TIME TO TAKE IT SERIOUSLY

No man likes to talk about it; erectile dysfunction is a taboo. For most affected men, it feels like a personal failure. It is stigmatised like a mental handicap and a physical incompetence. The word ‘impotence’ says it all.

WORDS DR. MANUELA REISBECK

Arecent European survey from 2020 showed quite surprising results: 51% of men between 40-70 years of age do suffer from ED, in the age group 80+ the prevalence reaches 86%. The shame and insecurity create further psychological problems and as a consequence, men do not talk about ED, not with their partners, not even with their doctors. Occasional blue pills may be prescribed with some effect, but the actual problem remains unaddressed. Which is a shame, because as most men don’t realise, the majority of causes for erectile dysfunction are physical and easily treatable. ED is a common consequence of diabetes, high blood pressure and atherosclerosis, all medical conditions which can be solved if diagnosed in time.

A Swiss study from 2019 showed that about 40% of men presenting with ED suffered from significant atherosclerosis. CT scans

of their pelvic arteries could demonstrate important narrowing of vessels to the genital organs. These blockages will impair the blood supply causing the feared symptom of inability to perform. In the majority of cases, these vascular blockages can be reopened with inflatable balloons and special metal stents. A similar surgery is being carried out for all sorts of arterial blockages in our body, best known as a treatment for heart attacks. The procedure is indeed very similar: following a small needle prick in the groin, injected contrast media will demonstrate the vascular lesion, and the stents are guided to the blocked area with the help of straw like catheters and hair thin wires. There is no anesthesia required, there is no cut and no wound, just a needle prick and a small band aid in the end.

As a conclusion, it appears that in a large number of cases ED is to be seen as and treated like any other vascular disease in the body. As such, it has risk factors which have led to the development of arterial blockages in general. These would be the usual suspects: diabetes, arterial hypertension, smoking and cholesterol. And in fact, a significant number of cardiac and vascular patients will report that they have suffered from ED for years but did not dare to tell anybody. While their coronary arteries were already fixed, they still struggle with an important aspect of their quality of life.

Nevertheless, ED does result from other causes as well. We should not forget the polyneuropathy secondary to diabetes (30%), hormonal imbalance (3%), neurologic and psychological causes (11%) – which brings awareness to the fact that ED clearly is not a purely urological disorder, but a multidisciplinary one requiring the combined efforts of different specialists such as urologists, internists, cardio-vascular specialists and endovascular/ interventional specialists, working together to understand why each individual patient suffers from ED and what could be the best treatment option to restore functionality and quality of life.

At UroCare, we are proud to have initiated an Erectile Dysfunction Care Board where each case evaluated by the urologist will be discussed to understand the underlying problem. After performing all necessary testing, we are confident that we will be able to offer the right treatment option, from simple testosterone injections and optimised diabetes control, to sophisticated minimally invasive endovascular interventions reopening vascular blockages and reinstating optimal blood flow.

g Please call or email us and we will provide more information. Ideally you will be booked in for a first consultation with our urology specialist. This is not the time to feel shame or resignation. ED is an important medical condition which must be addressed, even more so because it is a major concern to our quality of life.

UroCare is a branch of CardioCare Marbella. Tel: (+34) 952 779 680. info@cardiocaremarbella.com www.cardiocaremarbella.com

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