Erectile dysfunction (also commonly known as impotence) is when an erection sufficient for sexual intercourse cannot be achieved over a longer period of time. There can be many causes for this, which is why particular attention must be paid to an accurate diagnosis. Diagnostics include a detailed questioning of the patient followed by a thorough physical examination and the determination of metabolic and hormonal blood values.
Risk factors
The frequency of erectile dysfunction increases significantly with age. About half of people in their sixties and about two thirds of those in their seventies are affected. In addition to age, other risk factors include high blood pressure, diabetes mellitus, smoking, permanently high LDL cholesterol levels, obesity, lack of exercise and alcohol abuse. These are the same risk factors as cardiovascular diseases – which is why these diseases are closely linked to erectile dysfunction.
The penis - the beacon of the heart
Cardiovascular diseases such as heart attacks or strokes often have the same causes and the same risk factors as erectile dysfunction. Erectile dysfunction can be the first sign that there is an increased risk of cardiovascular disease.
It is therefore important, especially at an advanced age or if you belong to a risk group, to take erectile dysfunction seriously and discuss it with your family doctor or urologist. If the symptoms remain untreated, serious cardiovascular diseases such as stroke, myocardial infarction or peripheral arterial disease can result after a few years.
Treatment options
When treating impotence, we proceed according to the step-by-step principle depending on the cause of the dysfunction and first try to remedy the erectile dysfunction by changing the lifestyle and providing support with medication. If this does not produce acceptable results, we can gradually adjust the therapy.
The stages of therapy for erectile dysfunction
- Lifestyle changes: Some risk factors are within the patient’s control. Abstaining from addictive substances such as alcohol and nicotine, a balanced diet rich in vegetables and regular exercise, as well as good stress management can already help to eliminate the causes of impotence and support further therapeutic measures.
- Medication: Taking so-called PDE-5 inhibitors in tablet form can help to produce an erection within a short time if you have erectile dysfunction. Various medications are available with an onset of action after 15-60 minutes. It is not possible to take these tablets for certain heart conditions. There are also medications that can be injected into the erectile tissue of the penis at home (erectile tissue autoinjection therapy) or into the urethra using an applicator.
- Vascular surgery can improve blood circulation. This procedure is only recommended for younger men and if there is no general vascular disease.
- Implantation of erectile tissue prostheses. In cases of severe erectile dysfunction where other therapies have not been successful, a penile implant, also known as a penile prosthesis, can be surgically implanted. Two cylinders are implanted in the penis, which can be filled with fluid from a reservoir via a hand-operated pump in the scrotum. This allows an erection to be produced virtually at the touch of a button. After intercourse, the pump is used to pump the fluid back into the reservoir. This procedure is expensive and is not covered by health insurance.
- Psychotherapy. Psychological causes such as stress and depression can underlie impotence. Psychotherapy, which can also be designed as couples therapy, for example, can be helpful here.
Special consultation
In the impotence consultation at the Clinic for Urology, our specialists will treat your concerns discreetly and competently. In addition to a thorough search for the cause, we offer you all common treatment options tailored to your individual situation
Frequently asked questions about the treatment of erectile dysfunction
We obtain important information in a detailed discussion. The physical examination includes blood pressure measurement and palpation of the genitals. A blood test can provide information about the hormone status, blood sugar level and blood lipid values. We can check the blood flow to the vessels in the penis using ultrasound and a cavernous body test.
Medication such as Viagra and various aids are used if drug therapy is not effective or possible. Whenever possible, the methods are chosen so that the man can use them himself if necessary. For example, erectile tissue autoinjection therapy (SKAT), in which the man injects himself with an active substance that leads to an erection. Mechanical aids include penis rings, vacuum pumps and penile prostheses. A full 90 percent of men are extremely satisfied with the penile prosthesis. And since 2025, the costs of penile prostheses have even been covered by health insurance.
