Erectile Dysfunction (Male Impotence)

Penile erection is a physiological phenomenon where the penis becomes firmer, engorged and enlarged as a result of a complex interaction of psychological, neural, vascular and endocrine factors.

 

Erectile dysfunction (ED) is a sexual condition characterised by a man inability to achieve and/or maintain his penile erection during sexual performance. Common organic causes in ED are cardiovascular disease, diabetes, neurological problems (such as damage to the erectile nerves during surgery or following radiation therapy) and drug side effects. Unfortunately, as men get older, many men find it difficult for them to achieve and/or maintain an erection too.

 

 

The presence of ED is often distressing and can be associated with significant psychosocial dysfunctions such as perceived loss of masculinity and self-confident, fear of sexual intimacy, anxiety and depression. More importantly, the symptom of ED could be an early tell-tale sign of potential underlying cardiovascular risk factors such as hypertension, abnormal lipids, diabetes and heart disease.

 

Treatment options for erectile dysfunction

If you do experience problems achieving or maintaining an erection, there are a number of treatments that can help you. Tablets such as Viagra®, Levitra®, Cialis® and Spedra® are available to improve penile erection. Common side effects of these tablets include headaches and hot flushes. Men with history of cardio-vascular problems or taking anti-angina medication should consult their doctor prior to taking these tablets, as this method of treatment may not be appropriate.

Another popular form of treatment is penile injection. This involves injecting a substance into the base of the penis that dilates the blood vessels enabling them to fill with blood and thus creating an erection. This method is successful for most men who are willing to inject their penises, and it is essential for your doctor to work out an accurate dosage for you to prevent your erection lasting too long. Penile vacuum pump device also allows for men to achieve an erect penis and the use of penile constrictor band (or ring) helps men maintain their erection. Unfortunately, they can be cumbersome to apply and have several unwanted side effects.

Penile prosthesis implant can provide men with an artificial erection. While it is usually considered as the last option, it is probably the most effective treatment and offers the man the ability to achieve an (artificial) erection whenever he wants it and for as long as he needs the erection. The 3-piece inflatable penile prosthesis simulates “normal penile erection” and is usually the treatment of choice for men. As with all surgical procedures, there are risks associated with the anaesthetic, surgery and implant device that your urologist will discuss with you.

Professor Chung holds numerous distinguished posts in various organisations including being the Secretary-General for the Asia Pacific Society of Sexual Medicine; Chair of Scientific Committee at the International Society of Sexual Medicine; past Chair of the Andrology section in the Urological Society of Australia and New Zealand; and the Chairperson of the Prostate Cancer Survivorship for Sexual Health, Function and Rehabilitation committee at the International Consultation on Sexual Medicine, the peak authority body for the International Society of Sexual Medicine. He has published extensively on erectile dysfunction (see below) and is considered the leading authority in this field in Australia and around the world. He runs an active clinical trial unit, and has been invited to speak at many major international and national meetings.

It is essential that, if you are experiencing problems associated with erectile dysfunction, you discuss this matter with your family doctor or urologist.

Some of the key articles published by Professor Chung

  • Chung E. Male sexual dysfunction and rehabilitation strategies in the settings of salvage prostate cancer treatment. Int J Impot Research 2021;32(4):457-63
  • Chung E. Regenerative technology to restore and preserve erectile function in men following prostate cancer treatment: evidence for penile rehabilitation in the context of prostate cancer survivorship. Ther Adv Urol. 2021
  • Chung E, Cartmill R. Evaluation of long-term clinical outcomes and patient satisfaction rate following low intensity shock wave therapy in men with erectile dysfunction: A minimum 5-year follow-up on a prospective open-label single-arm clinical study. Sex Med. 2021;9(4):100384
  • Chung E, Ng BHS, Wang J, Can malleable penile prosthesis implantation improve voiding dysfunction in men with concurrent erectile dysfunction and buried penis? Investig Clin Urol. 2021;62(3):305-309
  • Chung E, Lee J, Liu CC, Taniguichi H, Zhou HL, Park HJ. Clinical practice guideline recommendation on the use of low intensity extracorporeal shock wave therapy and low intensity pulsed ultrasound shock wave therapy to treat erectile dysfunction: The Asia-Pacific Society for Sexual Medicine position statement. World J Mens Health 2021;39(1):1-8
  • Chung E, Bang-Ping J, Koichi N et al. Provision of sexual medicine services during the coronavirus disease-2019 pandemic: An Asia Pacific Society of Sexual Medicine position statement. Sex Med. 2020;8:325-26
  • Chung E. Penile prosthesis implant in the special populations: diabetics, neurogenic conditions, fibrotic cases, concurrent urinary incontinence, and salvage implants. Asian J Androl. 2020;22(1):39-44
  • Chung E. Sexuality in ageing male: Review of pathophysiology and treatment strategies for various male sexual dysfunctions. Med Sci (Basel). 2019;7(10). pii:E98
  • Chung E. A review of current and emerging therapeutic options for erectile dysfunction. Med Sci (Basel). 2019;7(9). pii:E91
  • Chung E. Contemporary and novel imaging studies for the evaluation of erectile dysfunction. Med Sci (Basel). 2019;7(8). pii:E87
  • Scott S, Roberts M, Chung E. Platelet-rich plasma and treatment of erectile dysfunction: Critical review of literature and global trends in platelet-rich plasma clinics. Sex Med Rev. 2019;7(2):306-12
  • Chung E. Penile reconstructive surgery in Peyronie’s disease: Challenges in restoring normal penis size, shape and function. World J Mens Health. 2018; 36:e10-17
  • Chung E, Wang J. A state-of-art review of low intensity extracorporeal shock wave therapy and lithotripter machines for the treatment of erectile dysfunction. Expert Rev Med Devices. 2017;14(12):929-34
  • Chung E. Management of treatment-related sexual complications in cancer care: Evidence for erectile function recovery and penile rehabilitation after radical prostatectomy in prostate cancer survivorship. Expert Rev Qual of Life Cancer Care. 2017;2(6):279-86
  • Chung E. Penile prosthesis implant: Scientific advances and technological innovations over the last four decades. Transl Androl Urol. 2017;6(1):37-45
  • Chung E. Stem-cell-based therapy in the file of urology: A review of stem cell basic science, clinical applications and future directions in the treatment of various sexual and urinary conditions. Expert Opin Biol Ther. 2015;15(11):1623-32
  • Chung E and Gillman M. Prostate cancer survivorship: A review of current literature in erectile dysfunction and the concept of penile rehabilitation following prostate cancer therapy. Med J Aust. 2014;200(10):582-5
  • Chung E and Brock G. Sexual rehabilitation and cancer survivorship: a state of art review of current literature and management strategies in male sexual dysfunction among prostate cancer survivors. J Sex Med. 2013;10(Suppl.1):102-11
  • Chung E, Van CT, Wilson I and Cartmill R. Penile prosthesis implantation for the treatment for male erectile dysfunction: clinical outcomes and lessons learnt after 955 procedures. World J Urol. 2013;31(3):591-5
  • Garcia FJ, Chung E and Brock B. Drug therapy for erectile dysfunction. In Male Sexual Dysfunction: A Clinical Guide. Chichester, UK: John Wiley & Sons Ltd.
  • Lee D, Chung E and Wang R. Chapter: Reoperation for penile prosthesis implantation. In: Biomaterials and Prostheses Implant in Urology
  • Al-Shaiji TF, Chung E and Brock GB. Chapter: Erectile dysfunction: Pharmacological Therapy. In: Cancer and Sexual Health. Current Clinical Urology Series. Springer Science and Business Media, LLC
  • Chung E. Chapter: Novel therapies for erectile dysfunction: Beyond current PDE5 inhibitors, intracavernosal vasoactive agents and penile prosthesis. In: Erectile Dysfunction: Causes, Risk Factors and Management. Nova Science Publishers, Inc, NY
  • Chung E. Chapter: Current and emerging novel diagnostic tools for the diagnosis of male erectile dysfunction. In: Erectile Dysfunction: Causes, Risk Factors and Management. Nova Science Publishers, Inc, NY