All methods of treating impotence are divided into conservative and operative.

Now, experts are convinced that in most cases, purely organic (ie, non-psychological) causes lead to impotence. All methods of treating impotence are divided into conservative and operative.

Conservative methods of treating impotence include drug therapy or the use of vacuum-constrictor devices (vacuum pumps).


Medication Therapy

More recently, the main drug used to treat impotence, was Yohimbin. The effectiveness of its application does not exceed 10 percent. The need for long-term use of the drug (up to a year) and low effectiveness of treatment, a large number of adverse reactions make this method of treatment unacceptable.

Currently, drugs “Viagra” (sildenafil), “Levitra” (vardenafil) and “Cialis” (tadalafil) are successfully used to combat impotence. The effectiveness of the drugs is unquestionable, but they can cause a lot of side effects.

Modern medicament preparations (so-called sexual dope), used in clinical practice, allow to achieve higher treatment efficiency, which reaches 70-80%. These drugs are characterized by the presence of side effects, such as minor headache, sudden redness of the face and neck, hyperemia of the nasal cavity, changes in color perception and visual acuity.

The method of intracavernous injections of vasoactive drugs

The essence of the method is microinjection of vasoactive drugs directly into the penis before sexual intercourse. The method of intracavernous injections of vasoactive drugs has become the most widespread and most effective among conservative methods of treating erectile dysfunction. For treatment, prostaglandin alprostadil is used, both in the form of monotherapy, and in various combinations.

A combination of drugs is used to reduce the side effects of each of them by reducing the concentration. The complex program approach to the appointment of intracavernous therapy makes it possible to make the application of this method effective and safe.

Intraurethral therapy for impotence

For intraurethral applications, various drugs are used, such as alprostadil. From the urethra, the drug is absorbed and enters the cavernous bodies with blood flow, where reactions that cause an erection occur. This method is similar to the previous one, but allows to exclude injection into the penis.

Currently, this therapy is not widely used because of the high cost of drugs and adverse reactions (burning sensation in the urethra), as well as the need for mandatory condom use.

Vacuum-constrictive therapy of impotence

The essence of the method is to create negative pressure in the cavernous bodies of the penis with the help of a vacuum cylinder and a pump, which causes blood flow and an erection held by applying a special compressive ring at the base of the penis, limiting the venous outflow. Thus, it becomes possible to perform sexual intercourse, which lasts no more than 30 minutes.

The effectiveness of the method is 40-50%. The drawbacks include the practical use of the device (it is impossible to hide from the partner and others), painful ejaculation (ejaculation) caused by the constricting ring, hemorrhages on the penis, a feeling of numbness in the penis.

Surgical treatment of impotence

Surgical intervention in recent years is used increasingly rarely because of the high effectiveness of drug therapy. Surgical methods are used in extreme cases, when conservative treatment does not give the desired results and for certain indications.

Operative treatment of venous insufficiency of the penis is performed in case of lesion of the veno-blocking mechanism of the penis. Despite the great age of this method, its effectiveness is about 50%. However, even with relatively low results, venous surgery of the penis is still used in clinical practice, as additional to other methods previously described, which allows achieving high results.

Surgical treatment is indicated in the case of insufficient arterial blood flow into the penis. Arterial microvascular shunting is performed, the efficiency of which varies from 30 to 50%. This operation shows high efficiency only in young patients.

Prosthesis of the penis is currently the main method of restoring the rigidity of the penis. Implantation of prostheses is the final stage in the treatment of impotence, when all previous methods of treatment failed.

Psychotherapeutic methods

In the issue of treating impotence, scientific medical advice sounds in unison to some of the heads of the Kama Sutra. The main role is given to the three-level technique of focusing sensuality. This technique advises during sexual intercourse to pay more attention to the satisfaction of the partner.

At the first stage, the partners deliver mutual pleasure without contact with the sexual organs. At the second stage, partners touch the genitals and erogenous zones of the partner, but do not have sexual intercourse. And only at the third stage there is sexual intercourse.

Hypoplasia of testicles: causes, effects on fertility and treatment

Hypoplasia of testicles is an anomaly of development of male genital glands, associated with a decrease in their size and, as a consequence, a violation of functions. This pathology is detected in about 5-8% of newborn boys. In terms of severity, hypoplasia can vary from a slight decrease in the testicle volume to a complete absence.


The main causes of the pathology are chromosomal mutations associated with:

  1. the addition of the X chromosome;
  2. X-chromosome mosaic (Klinefelter syndrome);
  3. transferring part of the female chromosome X to the male chromosome Y (Shereshevsky-Turner syndrome).

We should not forget about the pathological course of pregnancy associated with hormonal imbalance (for example, taking gestagens and estrogens) or the development of hormone-dependent adrenal and thyroid tumors in a future mother.

I would like to draw special attention to cryptorchidism. This disease is characterized by the absence of one or both testicles in the scrotum and their location in atypical sites (in the abdominal cavity, inguinal canals or on the inner surface of the thigh). If surgical treatment of pathology is carried out at a later date, and there are inflammatory diseases or a testicular torsion in history, these factors can become the causes of acquired hypoplasia of the male sex glands.

Anatomy and physiology of the testicles

Eggs – paired organ of oval form, volume about 15-25 ml, slightly flattened laterally.

Male gonads are in the scrotum and separated from each other by a septum. The left testicle is usually located below the right one. To the back surface of the texculum adjoining appendages, which pass into the vas deferens.

Eggs perform in the male body two main functions – reproductive and secretory.

Reproductive function is to ensure the formation and full maturation of spermatozoa. Otherwise, we are talking about male infertility. The secretory function is realized due to the production of testosterone hormone by Leydig cells, which is responsible for the development of the body according to the male phenotype, determining the condition of the musculoskeletal system and the features of the hair.

Classification of testicular hypoplasia

Hypoplasia of the testes is one- or two-sided. This determines the degree of manifestation and severity of the course of the disease.

With unilateral organ hypoplasia, symptoms are often absent altogether, or the only symptom of the disease may be scrotal asymmetry.

With bilateral damage to the testicles, there will be more pronounced violations of the basic functions of the tekkikul (secretory and reproductive).

Reduction of the secretory function is characterized by a decrease in the production of androgens, in connection with which the male body will develop according to the female type. When the reproductive function worsens, the process of formation and maturation of spermatozoa is disturbed.


Visual examination and palpation of the scrotum immediately allow us to note changes in the size of the testicles.

More accurate information is provided by the ultrasound method, which allows to estimate the volume, structure and blood supply of testicles.

It is equally important to conduct a study of the ejaculate with the determination of the concentration and total number of spermatozoa, their mobility and morphology.

To evaluate androgen saturation allow blood tests for the level of total testosterone, sex hormone binding globulin, and LH.


It is important to note that early detection, timely treatment gives a more pronounced clinical effect.

Restorative therapy consists in elimination of consequences of violation of secretory and reproductive function of testes.

Androgen deficiency is corrected by the use of substitution or stimulating therapy, the choice of which depends on the degree of damage to the testicle parenchyma.

Treatment of infertility requires a detailed study of violations of spermatogenesis. Perhaps the doctor will recommend the use of assisted reproductive technologies (ICSI).

Cosmetic defects can be leveled by implantation of the testicle of the testicle in the scrotum.

In this case, under a local or general anesthetic, a small incision of the skin is made, followed by the formation of a cavity where the prosthesis will be placed.

To reduce deformity of the scrotum, the prosthesis with clips is attached to the testicles.


Alcoholism and impotence

The terrible truth about impotence sounds unbelievable, but the problem of male impotence threatens every drinking person.

The terrible truth about impotence sounds unbelievable, but the problem of male impotence threatens every drinking person. Most of the men who consume alcohol do not even think that there may be problems. While these problems do not concern them. Usually impotence overtakes a man of 35-40 years, or even earlier. Many, until they encounter such a disease, simply do not want to admit and even believe that such a thing is possible. Most people listen to doctors’ advice, but believe that everything will turn out well. Moreover, at an early age, drinking alcohol on the contrary acts excitingly, increases the flow of blood to the pelvic organs, and most importantly – increases the duration of sexual intercourse. However, the cumulative effect of alcohol is terrible.

Decreased potency

First of all, the conditioned reflex starts to develop, which stimulates the man to drink before sexual intercourse. However, over time, the potency begins to deteriorate, since alcohol depresses sexual functions and the nervous system. A man wants to have sex less and less, but he explains it himself with fatigue, unattractiveness of his partner, stress, anything, not realizing that he is already on the verge of impotence.

Ejaculation is faster

Following the weakness of sexual functions comes rapid ejaculation, an even more severe decline, a sluggish erection. These phenomena can be called weakly expressed impotence. Then (unexpectedly for a drinking man), a moment comes when the erection does not arise at all. Accepting this fact for a misfire (with whom it does not happen!), It may not pay attention, but such situations begin to be repeated more often, until it becomes obvious.

There comes a psychological impotence

The partner begins to hint about weakness, the man has a self-esteem, and along with the physiological impotence comes the psychological.

Why is alcohol due to impotence?

Long-term use of alcoholic beverages, as shown by the analysis, leads to pathological changes in the prostate gland. Over time, the cavernous bodies of the reproductive organ lose the ability to fill with blood, and as a result, become elastic, which leads to a depreciation of the sexual act. Because alcohol destroys the coordinated work of the nervous system, the drinker’s sensitivity decreases during sex. This, by the way, is due to the duration of sexual intercourse during intoxication, than men are so proud of. In fact, signals about excitation and inhibition simply do not reach the brain areas in time, and the person is disoriented.

The earlier a man begins to drink, the faster he becomes insolvent, often by the age of 25 he becomes impotent. If a man is addicted to alcohol later than the sexually mature age (after 20-22 years), then in this case his sexual functions are extinguished, but it is much more dangerous that he begins to degrade psychologically when he is excited by more primitive and gross things not related to thin and high sensations. With age (around 40 years), interest in sex completely disappears, precisely because simple stimuli no longer attract, and the more delicate ways of self-excitation the psyche is no longer capable. As a result, sex is simply boring and uninteresting to a person, which is the main cause of impotence, because, following unwillingness, there is a decrease in the number of sexual contacts and the dying off of sexual functions.

Some men believe that as a counterexample, you can bring people who drink alcohol, but “keep good”. But, firstly, this is an exception to the rule, and, secondly, in words, men tend to exaggerate their merits and keep silent about the problems. Statistics stubbornly maintain the opposite: in 50% of patients who are in the second and even the first stage of alcoholism, there are systematic erectile dysfunction or even complete impotence. At the first stage cleaning of the body can help, but we must understand that the best prevention of impotence will be maximum abstinence from drinking.

Do you suffer from alcoholism and found signs of impotence? What to do?

First of all, do not wait until the problem worsens. The earlier you turn to narcologists, the more effective and quicker restore the potency. Note that the drug treatment of impotence is possible, but only if refuses to drink, which means that the ailment should be treated only in combination.

The editors thank the specialists of the company “Alkomed” for their help in preparing the material.

Causes of impotence

The idea that in the impotence is guilty of an incorrect emotional attitude, long possessed the minds of doctors. Today, the weakness of the stronger sex is increasingly explained by all sorts of problems and malfunctions in the work of internal organs.

The most common failure in the life of a man – so called impotence known psychotherapist Sigmund Freud. Since that time, medicine has achieved much, to the smallest detail, technologies for diagnosing and treating sexual impotence have been developed. But even now problems with potency – the strongest blow to male vanity.

Statistics of impotence

Two out of ten representatives of the stronger sex suffer from erectile dysfunction. Only one in ten men, faced with sexual disorders, turns to a specialist.

In 90% of cases, an erection can be restored.

In 80% of men impotence has physiological causes and signals about any unhappiness in the body.

About what diseases can signal impotence (erectile dysfunction).

  1. Leading the list of disagreements with the psyche, which have become chronic – neurotic disorders, depression. In this case, the erection depends on the emotional state. Sometimes a full sexual intercourse is possible only if certain conditions are met. For example, a man “everything works” only with a certain partner, at certain times of the day or after masturbation.
  2. Common causes of sexual disorders – diabetes, alcoholism, drug addiction, intoxication, metabolic disorders. With these diseases, the transmission of impulses along sensitive and motor fibers is impaired, which means that the reflex arc providing an erection suffers.
  3. Problems with potency sometimes appear after injuries or diseases of the spinal cord and brain. Often, erectile dysfunction is the first symptom of an infectious lesion, trauma, tumor, epilepsy or Parkinson’s disease.
  4. Noticeably decreases the sexual desire for hormonal disorders. As a rule, this occurs against the background of a lack of male sex hormones or with an excess of female hormones.
  5. Atherosclerosis, birth defects and other vascular diseases also threaten impotence. The fact is that such disorders prevent the normal flow of blood to the cavernous bodies of the penis.
  6. Impotence can also develop as a side effect of taking medications. The erection is affected by antidepressants, neuroleptics, tranquilizers, drugs that treat hypertension, and those that lower gastric secretion.
  7. For sexual failures, sometimes inflammatory diseases of the prostate, urethra, bladder and testicles are concealed. In general, any chronic illnesses, nervous and physical fatigue do not have the best effect on male power.

How to understand the causes of impotence?

To exclude urogenital diseases, consultation of the urologist or andrologist, with the subsequent ultrasonic research, delivery of analyzes of a blood and a semen, extraction of bacteriological smears is necessary.

If there is a suspicion that your problem is associated with hormonal disorders, contact an endocrinologist. You may need ultrasound examination of the endocrine glands, computed tomography. Laboratory diagnostics will help to establish the level of a hormone in the blood.

Vascular disorders are detected using ultrasound dopplerography. Modern methods allow to determine quantitative and qualitative indicators of blood supply to the penis. For the same purpose, functional tests are assigned. In the cavernous bodies of the penis, vasodilator drugs are administered. In this case, the blood pressure in the arteries of the penis and brachial artery is compared.

The neurologist will help to eliminate diseases of the spinal cord and brain, as well as peripheral nerves. For this, several complex studies are sometimes prescribed: tomography of the brain and spinal cord, electroencephalography, electromyography, rheoencephalography.

A psychotherapist, a sex therapist or a psychiatrist should evaluate the psychic component of a sexual disorder. The main diagnostic technology used by these specialists is a conversation with the patient, various methods of psychological testing.


For a long time, the diagnosis of “impotence” was put to all men without exception, who complained to the doctor for reducing the duration and strength of the erection.

Impotence is the absence of erection penis in men, leading to the inability to conduct sexual intercourse. Often this pathological condition is accompanied by a lack of desire (libido) and sensation of orgasm, accelerated ejaculation, which, of course, significantly reduces the quality (and quantity) of sexual activity and has a negative impact on the psycho-emotional status of men, interpersonal and family relationships.

What is impotence?

For a long time, the diagnosis of “impotence” was put to all men without exception, who complained to the doctor for reducing the duration and strength of the erection. However, in a large number of these patients, the erection is retained, just the strength of it is not enough to conduct a normal sexual intercourse.

In addition, it was found that men with a decreased quality of erection are much more than with its complete absence. So now more often in the course of the term “erectile dysfunction”, i.e. erectile dysfunction, and impotence is simply an extreme degree of these disorders.

There are also secondary impotence, when the normal erection still was before, and the primary – in those cases when there was never a normal erection. It is believed that the sexual function is weakened over time. In fact, this is not so. In the absence of diseases that cause erectile dysfunction, every man can have a quality sexual life in both 50 and 60 years.

Why it happens?

Previously, it was believed that the main causes of impotence are the problems of psychological properties or impaired metabolism of sex hormones. However, it is now clear that although the psychological factor contributes to the development of the disease, the main cause is organic changes in the mechanism of erection.

According to the latest data, among the main causes of impotence and erectile dysfunction are:

  • Mental: depression, stress.
  • Nervous: trauma, intervertebral disc damage, multiple sclerosis, alcohol abuse, pelvic surgery, etc.
  • Arterial: hypertension, smoking, diabetes.
  • Venous: violations in the mechanism of limiting the outflow of blood from the penis.
  • Medicinal: the use of pressure-lowering drugs, antidepressants, luteinizing hormone, some other medicines.

What’s happening?

There are many reasons, but the main culprits for reducing potency are progressive atherosclerosis, diabetes mellitus, hypertension, tobacco and alcohol dependence. With these diseases there are changes in the blood vessels of the body, as a result of which the walls of veins and arteries lose flexibility and elasticity, become brittle and brittle, which is one of the most frequent causes of impotence.

In a normal state, under the action of central nervous system impulses, the walls of the vessels of the penis relax, so that the blood quickly fills the penis. Increasing in the volume of the artery squeezes small vessels through which, in an unexcited state, blood is discharged into the veins; the outflow of blood sharply decreases, which provides an erection.

However, the progression of atherosclerosis and, as a consequence, the deposition of cholesterol plaques on the walls of blood vessels, the use of drugs that reduce blood pressure, diabetic vascular lesions, alcohol abuse, stress loads – all this, together and separately, reduces the ability to normal erection.



  1. I need a lot of time to recover from the act. Such an age is already, probably. I tried Cialis, good pills, but it’s expensive for me. But recently nashol generic, it turned out, the action is the same, but the price is quite normal. I buy it only – it’s a thing!

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