Let's Talk Sex
September 14, 2010
Medical treatment for physical impotence

Medical treatment for impotence has changed dramatically from the use of contraptions like vacuums and implants to injections like Caverject and Trimix to tablets like Uprima and Yohimbine to the latest and best Viagra and its brothers.{{more}}

I will briefly describe the earlier ones. As late as the 80s when a man had impotence and nothing else worked, especially if he had any deformity of the penis we, urologists would advise him to have a penile implant. Implants are basically “plastic or silicone” tubes that are placed in the penis under an anesthetic. They are solid or malleable, so the penis is always erect and can be “bent” out of the way or they can be hollow and hence inflated with air or fluid using a pump. In this way it can be “pumped up” and used when necessary.

Vacuums are still being used to treat men who cannot or will not use Viagra or injections. Basically, the vacuum cylinder sits over the limp penis pressed against the bottom of the “belly” or the pubic area around the base of the penis. The vacuum is turned on and this draws blood into the penis. A rubber band is then rolled over the erect penis to “keep” the erection. Obviously, this method is cumbersome but is still being used by a few couples that have learned and perfected the art and are comfortable with it.

Before Viagra, most men with impotence used either Trimix or Caverject. These were injected into the shaft of the limp penis using a needle and syringe. The needle was very fine; hence, the pain or discomfort was less than giving yourself insulin. An erection was achieved in 15-20 minutes and generally lasted for about an hour. Caverject was safer as it used a substance naturally present in the body but Trimix was slightly stronger as it has two other substances including the one found in Caverject. These substances are still available for those not fit enough to use Viagra. The only problems are price (especially Caverject), injection site pain and scarring and overdosing (hence the dose has to be “measured” by a doctor and the procedure taught to the patient before it is dispensed; just like insulin!). Uprima and Yohimbine predated Viagra but Uprima fell into disrepute due to side effects (nausea and headaches in up to 40% of men using it. Can you imagine feeling nauseous or having a splitting headache just after sex!). Yohimbine is still being used in some OTC and herbal preparations, so we will be discussing it in our next issue on herbal remedies. MUSE was a medicated pellet that was inserted into the urine passage of the penis. It was the same medication that was in Caverject but it was not injected. It fell by the wayside also because of urine passage pain and scarring. The medication found in MUSE and Caverject cannot like insulin be taken in a tablet form because it will be digested by the stomach acid and intestinal juices.

Next week we will continue with our discussion on the medical treatment for physical impotence and look at medications such as Viagra, Cialis and Levitra.

For comments or question contact:

Dr. Rohan Deshong

Tel: (784) 456-2785

email: [email protected]