The Truth About Impotence - Is Vasectomy Related to Impotence?

Written by Krista

DR. GOLDSTEIN: For some reason we get people who always think that a vasectomy is related to impotence. There is no relationship that I can report from multiple studies studying thousands of men who under control situations didn't have a vasectomy, or under situations had a vasectomy and looking at things like erectile problems. People are also concerned of vasectomy in prostate cancer, and there's absolutely no relationship between vasectomy and prostate cancer. Having a reversal could happen, but if you are hoping it reverses your impotence, it won't. A 58-year-old male would most likely have erection problems from vascular disease, such as cigarette smoking or diabetes or high cholesterol. I would suggest you seek your doctor. And if you like, undergo testing. But specifically, you could simply try Viagra and see if it restores your potency, even though you have had a vasectomy.

KEN BADER: A 49-year-old woman listener in Massachusetts writes, "My husband has had a problem with not being able to get as hard as he used to. He gets an erection but it is easily bendable and reduces my pleasure drastically. He also takes much longer to have an orgasm. He is 46 years old and this has been going on for a few years." She asks, "Would Viagra be a good option for him?"

DR. GOLDSTEIN: Wow, this is a great question because someone asked earlier, do normal people,

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would benefit from Viagra. Now since you are sexually active and really he is at least hard enough to penetrate in you, some people may think that "he's normal." When obviously, as you state, he's not as hard. He has longer to achieve orgasm. There are sexual dysfunctions going on here. Yes, by all means, he would be an excellent candidate for Viagra. He is actually the ideal, in fact, candidate for Viagra. Since he's in his 40s and has erection problems, you might want to have him undergo testing to see if there are early vascular conditions. Because if there are, perhaps maybe he could get a cardiac stress test and see if other vascular conditions are abnormal such as the blood circulation to his heart, which would be very important to know.

KEN BADER: Here's a listener from North Carolina. He's a gentleman and he asks this question. "Can I use the vacuum therapy and Viagra at the same time?" Here's a bit of background he provides. "I am 58 years old with a radical prostate removal because of cancer. The cancer was contained in the prostate. I have not had good success with the injection. I could not get it stiff enough for penetration. I was using 1.0 strength with the injection." He says, "The vacuum method does not get it stiff enough for good penetration."

DR. GOLDSTEIN: Your question is can vacuum constriction devices be made better by taking Viagra? Well, the data is not in since Viagra is so new. But we are presently using Viagra alone, we're using Viagra with pellet therapy, using Viagra with shot therapy, using Viagra with implant therapy, and Viagra with vacuum constriction device therapy. And we're now even using Viagra to enhance erections at night. So we are just discovering the magical ways Viagra can help men and their sexual dysfunctions. And of course, we're now using Viagra in women. So we're now seeing how Viagra works in all of this. I would encourage you to try all therapies to help your situation. Injections are not functioning and the vacuum device is not perfect. So maybe Viagra will turn the corner. Of course, the other option is you can undergo a penile implant, should you desire to enhance your sexual function.

KEN BADER: A quick question from a 47-year-old fellow in Massachusetts. He asks, "Is there any connection between circumcision and impotence?"

DR. GOLDSTEIN: We often get that question as we do with the vasectomy. In this particular situation I unfortunately have seen a case where an odd complication happened during circumcision that actually did cause the erection problems. So this is a little different than vasectomy. Although for the most cases, circumcisions are entirely benign and rarely are the reasons for erection problems. Since you are in your 40s and having an erection problem, I would strongly encourage you to seek a local doctor and get an evaluation.

KEN BADER: Here is the last question we have time for tonight, and it's a very good one. It comes from a 32-year-old gentleman in South Carolina. He asks, "I would like to know, what are the preventive actions to take against impotence?" A very good question.

DR. GOLDSTEIN: Spectacular question. The ones that are obvious are don't ride a bicycle. Don't smash your crotch in karate. Don't fall on fence posts. So preventing trauma and respecting the perineum. That would be my favorite. The most obvious, obviously, is to prevent the ravages of aging by taking control of your blood pressure. Keeping your weight down. Not having diabetes or at least if you have diabetes to get the maximum control you can. To avoid using drugs unless you have an obvious medical problem, because oftentimes drugs influence erectile performance. And the final answer, as it concerns preventative, is the concept of using Viagra to enhance the duration of nighttime erections. We have substantial evidence that would show that men who start becoming impotent start losing their night erections. That's one of the first things they see. We're hoping that if we get men at this early level where they're now starting to see just the beginnings of night ere ctions that they used to get, easily and routinely, that they're now not getting, is to start taking drugs like Viagra or other ones as they become available, to enhance night erections. We hope to actually prevent impotence with all these measures.

KEN BADER: Dr. Goldstein, this has been a most enlightening and fascinating hour. Thank you very much for being here.

DR. GOLDSTEIN: Ken, really, thank you for the opportunity to be here, and I thank all of the people for their great questions. They really were a typical day in the office.

KEN BADER: Well, on behalf of Dr. Irwin Goldstein and the staff of NOVA, I'm Ken Bader in Boston, thanking you for joining us and wishing you a very good night.