About Male Sexual Dysfunction
Erectile Dysfunction (ED)
Erectile dysfunction is defined as being unable to get or keep an erection that is firm enough to have sex. If you think you have ED and haven’t tried any medications, make an appointment with your primary care doctor first. For most men, a prescription from your primary care doctor is enough to treat ED. Duke urologists can help if medications have failed.
Peyronie’s Disease
Peyronie’s Disease is a form of erectile dysfunction and refers to a build-up of collagen, plaque or scar tissue that causes the penis to bend, curve or form an hourglass deformity, which makes erection painful.
Ejaculation Disorders
- Premature ejaculation refers to ejaculation that occurs before or soon after penetration.
- Inhibited or delayed ejaculation means ejaculation is slow to occur.
- Retrograde ejaculation refers to semen being forced back into the bladder at orgasm, instead of leaving the body through the urethra and out the penis.
Ejaculation Disorders Treatments
Behavioral Techniques
Your doctor may instruct you in several behavioral changes that can help you learn to delay ejaculation during sex.
Psychological Counseling
May be recommended to help reduce performance anxiety and help you find better ways to cope with stress.
Topical Anesthetics
May be recommended to reduce sensation and help delay ejaculation during sex.
Medication
Medications that keep the bladder neck muscle closed during ejaculation may be prescribed if retrograde ejaculation results in male infertility. Other medications may be prescribed to delay ejaculation.
Erectile Dysfunction and Peyronie's Disease
Lifestyle Changes
If you do not have an underlying health problem or physical abnormality, your doctor may suggest an exercise regimen, dietary changes and relaxation techniques that can increase your interest or sexual desire. Smoking cessation is encouraged and current medications are evaluated to look for pharmacological causes of ED.
Psychological Counseling
May be recommended as the first line of treatment for people with depression or anxiety.
Penis Pump
The vacuum erection device is a hollow tube with a hand- or battery-powered pump that promotes erection by increasing blood flow to the penis. It may be recommended if medication is not effective.
Penile Implant
A safe, reliable and effective treatment for erectile dysfunction (ED) and Peyronie’s Disease. An inflatable prosthetic device inserted directly into the penis to provide an erection suitable for intercourse. This minimally invasive procedure is performed through small incisions which minimizes blood loss and recovery time. We use a minimally invasive technique through a small incision which allows quicker return to normal activity.
Injections and Traction Therapy
A medication is injected into the Peyronie’s scar to straighten the penis without invasive surgery. Traction devices apply upward tension on the penis to stretch it. Over time, this reduces the curvature caused by Peyronie’s Disease.
Penile Plication
Straightens a penis bent by Peyronie’s Disease. Stitches gather tissue along the longer side of the penis so that it matches the short side.
Penile Grafting
Lengthens the shorter side of the penis by removing the scar tissue and adding healthy tissue (graft). Occasionally, grafting may be combined with a penile implant.
