What is erectile dysfunction?
Erectile dysfunction or impotence is a medical condition in which sufferers lose the ability to achieve or maintain an erection sufficient for satisfactory sexual intercourse. The prevalence of erectile dysfunction in Indonesia is estimated to reach around 35.6% and tends to increase with age. Erectile dysfunction disorders in the wider community are often considered a taboo matter, so many patients with these complaints feel embarrassed to consult directly with a doctor. It should be noted that erectile dysfunction can be related to other medical conditions such as hypertension, diabetes, high cholesterol, heart disease, hormonal disorders, stress and depression. Erectile dysfunction disorders accompanied by comorbidities if not checked and treated properly can have a negative impact on the patient's mental and physical health which can also reduce the quality of life.
What causes erectile dysfunction?
The causes of erectile dysfunction are multifactorial, ranging from psychological factors, male reproductive hormone disorders to comorbid diseases such as diabetes mellitus, hypertension and hypercholesterolemia. The comorbid diseases mentioned above can cause impaired function of the endothelium of the blood vessels in the penis, where the endothelium plays an important role in the erection process. Apart from that, several antidepressants, psychotropic drugs and prostate cancer drugs can also increase the risk of erectile dysfunction in patients who regularly take these drugs. In some cases, erectile dysfunction is also often found in patients with a history of spinal injury, pelvic bones and direct injury to the male vital organs.
How is the latest treatment for erectile dysfunction?
Treating erectile dysfunction must use a comprehensive approach. If erectile dysfunction is accompanied by a history of diabetes mellitus, hypertension or hypercholesterolemia, the treating urologist must work together with a specialist in internal medicine to treat the comorbid diseases suffered by the patient. In cases where erectile dysfunction may be influenced by stress, anxiety, depression or interpersonal problems in the husband and wife relationship or problems at work, then providing psychotherapy by a mental health specialist becomes an important component in the management of erectile dysfunction.
In general, urology specialists will recommend making healthy lifestyle changes such as exercising regularly for at least 30 minutes 3 times a week and recommend losing weight if the patient is overweight. Sometimes direct consultation with a Clinical Nutrition specialist will also be recommended to help create a healthy diet plan that the patient can consume at home. It is also recommended that you stop smoking or drinking alcohol.
Medical management includes administering oral medication, intracavernous injection medication where the medication is injected directly into vital organs, erection enhancing cream medication which is inserted into vital organs directly and also administering testosterone hormone therapy in cases where there is a decrease in the testosterone hormone in the body. Medical treatment for erectile dysfunction has good effectiveness in improving erectile function, but these drugs must be taken regularly or on-demand to get the desired results. Until now there has been no oral medication or other medicines that can have the effect of permanently increasing blood flow to vital organs until the use of Li-ESWT technology.
Several studies have found that administering low-intensity shock wave therapy (Li-ESWT) to a man's vital organs once a week for 6 weeks can signal the formation of new blood vessels (Neoangiogenesis) in the erectile tissue of vital organs, followed by increased blood flow to vital organs. This can help to improve erectile function so that patients achieve and maintain an erection sufficient for satisfactory sexual intercourse. Giving shock waves once a week for 6 weeks is known to increase the hardness of the erectile function of vital organs and the effects are long-lasting.
Article written by dr. Isaac Ardianson Deswanto, Sp.U (Urology Specialist Doctor at EMC Tangerang Hospital).