Erectile dysfunction

The penis consists of three erectile bodies: the urethral corpus cavernosum with the glans on the underside of the penis, and two erectile bodies on the top responsible for erection. A complex interplay of hormonal impulses and nerve impulses cause erection or erectile rigidity in intact erectile tissue. Functional and structural changes can lead to erectile dysfunction. The underlying cause must be diagnosed before treatment, to ensure that the correct treatment is used.

Questions about the diagnosis and treatment of erectile dysfunction

Erectile dysfunction is the inability to get or keep an erection. It is diagnosed as erectile dysfunction when the issue persists for at least six months. In over 70% of cases, erectile dysfunction prevents satisfactory sexual intercourse.

No, erectile dysfunction does not normally occur for extended periods of time, even though it is very common after a certain age. Temporary erectile dysfunction is far more common.

This varies from person to person. Between the ages of 40 and 50, every tenth man has problems with erections. The curve rises steeply after the age of 50; between 60 and 70, about one in three men has difficulties. .

As is often the case in medicine, a healthy lifestyle helps prevent erection issues. However, once these have occurred, urological care is necessary as home remedies are usually not effective.

In addition to a detailed interview and a physical examination, laboratory tests are carried out to determine the cause. The level of testosterone is also determined. Usually an artificial erection is induced with medication and ultrasound is used to examine whether the penis is sufficiently supplied with blood, an examination known as an angiodynography.

This depends entirely on the cause of the disease, as there are many reasons for erectile dysfunction. In addition to hormone and nerve changes, defects in the blood vessels can cause problems. Other causes can be systemic diseases such as diabetes or thyroid dysfunctions, as well as various medications and psychological problems. Penile curvature (IPP) can also lead to erectile dysfunction.

Generally speaking, if the underlying disease is successfully treated, erectile dysfunction is curable. If, on the other hand, there are structural defects causing the issues, usually only symptomatic treatment help.

The first step in the treatment of erectile dysfunction is medication. If the medication does not work or ceases to work after a period of time, various other options can be explored. Shock wave therapy (ESWT) is painless and has a positive effect as a mild treatment. Another promising option is the injection of a drug into the erectile tissue that causes an “artificial” erection (SKAT). Finally, surgical treatment consisting of the insertion of artificial erectile tissue (erectile tissue prosthesis) is also an option.

About this page:


Prof. Dr. med. Sven Lahme
Urology specialist

Medical director of the Goldstadt-Privatklinik.
Specialist for Urology, Mini-PCNL and robot-assisted da Vinci procedures.

Member in Scientific Societies and Reviewer of scientific journals.

Creation Date: 08.03.2020Modification date: 08.03.2020