Surgical treatments can be effective in the erectile dysfunction caused by vascular problems. However, surgical treatments must be considered only after methods such as shock wave therapy (ESWT) and medicinal treatments are tried and failed. The most commonly used surgical treatment method for erectile dysfunction is penile prosthesis implantation surgery. With the penile prostheses, a pleasant sexual life is possible even in older ages.
The hardening of the penis (erection) is a complicated process in which hormones, nerves, vessels, and also psychological factors play a role. Erectile dysfunction may arise due to any problem in any stage of this process. Therefore, erectile dysfunction may result from biological/organic problems related to hormones, or from completely psychological problems.
Sometimes the psychological problems are added on the biological problems, causing the situation to get more complicated. To solve the problem in the right way, the underlying reason or reasons must be analyzed well.
Sexuality in people is a process consisting of biological, psychological, and social factors. Being biologically healthy is not sufficient for the penis to get erected. Psychological factors are as effective as biological and organic factors in the erection mechanism. Since sexuality in men is mostly focused on performance and score, the fear of not being able to show the same performance all the time is called performance anxiety and is one of the common causes of erectile dysfunction.