Erectile Dysfunction and Urinary Incontinence

Among the various specializations of medical science is urology that studies urinary tracts of males and females and male reproductive system. The surgeons specializing in the fields of urology are called urologist who may diagnose, treat and manage disorders such as erectile dysfunction in men and urinary incontinence in women.

An erectile dysfunction is a sexual dysfunction where a man is unable to develop or maintain an erection of the penis during sexual activity. Usually, to achieve a normal erection may require coordination between vascular, neurologic, hormonal and psychological factors. Any condition or factor that may interfere with the coordination may cause erectile dysfunction. The causes of erectile dysfunction are generally grouped into either endogenous factors or exogenous factors. The endogenous factors include endocrine imbalances, cardiovascular, other medical conditions and emotional causes. On the other hand, exogenous factors may include medications, surgery, trauma, irradiation, smoking, alcohol and substance abuse.

Similarly, in women, urinary incontinence is the inability of the urine to keep leaking from urethra. Urethra is the tube carrying urine out of body from bladder. Urinary incontinence may be classified as 

·         Stress incontinence. It may occur during coughing, sneezing, laughing or exercise.

·         Urge incontinence. It may create a strong and sudden need to urinate followed by bladder contraction and loss of urine.

·        Overflow incontinence. It may occur because of the bladder not able to empty completely resulting in dribbling.

Urinary incontinence may be caused by neuromuscular disorders, dementia, medications such as diuretics, antidepressants, tranquilizers, antihistamines, etc., pregnancy, infection or inflammation of urinary tract, weight gain, Alzheimer’s disease, bladder cancer and spasms, pelvic prolapse and spinal injuries.

During an initial treatment at Dr. Safir’s the patient may be asked to alter their lifestyle by avoid smoking, reduce obesity and control alcohol and substance abuse. The patient may be prescribed medications such as Viagra that has a longer effect, increases penile blood flow and produces erection. Also, penile prostheses may be used that are semi-rigid or inflatable devices. During the procedure, the patient may be administered general anesthesia and incisions are made in the abdomen and perineum. The device is inserted through these incisions along with fluid reservoir and pump that are placed in groin and scrotum respectively. The devices are connected by tubes and may be tested before closing the incisions.

The treatment for urinary incontinence at Dr. Safir’s follows many approaches. It may involve methods such as bladder retraining and kegel exercises. Both these methods may help to strengthen the muscles of pelvic floor. In some cases, surgeries such as anterior vaginal repair and vaginal sling procedures may be performed. An anterior vaginal wall repair may tighten the front wall of the vagina. It either sinks the bladder into the vagina or sinks urethra into the vagina. On the other hand, in a vaginal sling procedure,  a sling made of mesh tape or tissue graft is used that supports urethra.