With the arrival of Viagra (sildenafil citrate), oral medication has become the first line of therapy for men with erectile dysfunction (ED).

But what about men who fail to respond to oral medications? They may choose second-line therapies such as intraurethral prostaglandins, penile injection therapy, sex therapy, or a vacuum erection device. For those who find these therapies unpalatable or inadequate, surgical intervention can be an option.

Surgical options for sexual dysfunctions

Arterial revascularisation

The term revascularization simply means to restore blood flow to the heart or another organ after the arteries have become clogged with cholesterol plaque. 

Venus leak surgery

Penile venous surgery is recommended only for young men who have ED as result of congenital or traumatic venous leakage of the penis. The procedure is performed to improve the trapping of blood in the penis, improving a man's ability to get and maintain an erection.

Penile Prosthesis

Implanting malleable rods surgically within the erection chamber of the penis

Phalloplasty Procedures

A multi-staged procedure that may include a variety of different procedures, including creation of the penis and lengthening the urethra so you are able to stand to pee.

While the success rate of revascularisation is extremely low, penile prosthesis implantation is used as the last resort.

Dr Saxena is uro-andrologist at Indraprastha Apollo Hospitals, New Delhi. He specialises in treating prostate disease and impotence using a bloodless technique called vapour resection. He is also the founder president of Andrology India