Duncan, BC

Dr. Alexander Anzarut, M.D.

Male Sexual Function

This is categorized under:

Male sexual function disorders are common among men of all ages, ethnicities, and cultural backgrounds.

Some of the disorders that can occur include:

  • Erectile Dysfunction (Impotence)
  • Peyronie's Disease
  • Priapism

Peyronie's Disease

Peyronie's disease is caused by the formation of dense, fibrous scar tissue, or plaque, in the penis' tunica albuginea -- the sheath that surrounds the erectile tissue.

Peyronie's disease affects about 3 percent of men middle-age and older. Although it can affect men of any race and age, it is most commonly seen in Caucasian males above the age of 40, especially those of blood type A+.

The cause of Peyronie's disease is not completely known. However, factors such as genetics and trauma to the penis, which may occur due to injury or invasive penile procedures, may contribute to the disease.

Due to the formation of scar tissue in the penis, patients with Peyronie's disease may experience pain and a curvature or distortion, such as a shortening or narrowing of the penis during an erection. In severe cases, these symptoms may lead to erectile dysfunction.

In about 15 percent of cases, Peyronie's disease spontaneously resolves itself without treatment. However, more than 40 percent of cases may worsen. If treatment is necessary, oral medications, injections, iontophoresis (painless current of electricity delivers and agent under the skin into the plaque), or surgery may be used. Therapy for the condition aims to relieve symptoms and preserve erectile function.

Surgery has been shown to be the most effective treatment for Peyronie's disease to correct the curvature of the penis. However, it is usually only recommended in severe cases for patients who fail to respond to non-surgical therapy and have curvature for longer than 12 months.

Priapism

Priapism is an uncommon condition that causes a prolonged and often painful erection, which occurs without sexual stimulation.

In a third of the cases, the cause is unknown. The remaining cases are caused by an associated condition, including:

  • Sickle cell disease
  • Pelvic tumors
  • Pelvic infections
  • Leukemia
  • Genital trauma
  • Spinal cord trauma
  • Medications
  • Recreational drugs

Priapism is classified into two types — ischemic (no-flow) or non-ischemic (high-flow).

  • Ischemic Priapism — This is the most common form of priapism and usually occurs with several hours or days of a painful erection. It is caused by an obstruction in the penis' venous drainage, which results in a buildup of poorly oxygenated blood in the corpora cavernosa, the tissue that forms the bulk of the erectile body of the penis.

    Ischemic priapism is considered a medical emergency and requires immediate treatment. If left untreated, the condition can significantly damage erectile function, by causing extensive scar tissue build-up and impotence.

    In the early stages of ischemic priapism, a cold shower or ice pack may relieve symptoms. Exercise in the form of climbing stairs also may help. Medications, such as analgesics and opiates to control pain, may be recommended as well. Other treatments for the condition include intracavernous drug therapy and shunt surgery.

  • Non-ischemic Priapism — This type of priapism is not as common or painful. It is usually caused by an injury to the penis or perineum-the area between the scrotum and anus. The injury causes the artery within the erectile body to rupture and thus pumping large amount of blood to the penis continuously.

    This condition does not require urgent treatment and in some cases, the condition may resolve itself spontaneously after days or months, at which point erectile capacity returns to normal. In some instances where treatment is necessary, ebolization or surgical ligation (tying off the ruptured artery) may be recommended.

Treatment for all forms of priapism aims to eliminate the erection and pain and preserve normal erectile function. Doctors recommend that anyone experiencing an erection lasting four hours should seek medical evaluation and treatment.