Erectile dysfunction is the inability to obtain and maintain an erection of sufficient quality to allow satisfactory sexual function between a man and his partner. There are various risk factors for erectile dysfunction but the most influential is increasing age. Other medical conditions maybe associated with erectile dysfunction such as high blood pressure and diabetes, hormone imbalance such as low testosterone or thyroid dysfunction may also be associated with erectile dysfunction. Patients undergoing surgery for bowel, bladder or prostate cancer may also suffer post-operative erectile dysfunction. Treatment for erectile dysfunction usually takes place in a step wise manner initially starting with lifestyle modification perhaps tablet treatment moving onto creams, injections and even vacuum devices. As a final resort patients may opt to have a penile implant inserted.
An overactive bladder is a condition suffered by both men and women. It is characterised by uninary frequency throughout the day and the night associated with a sudden compelling desire to pass urine. Patients may also complain of urinary incontinence because they cannot reach the bathroom quickly enough. There are several causes of an overactive bladder including urinary tract infection, bladder stones or even bladder cancer but in the great majority of patients the definitive cause is not found.
Various investigations will be performed in order to delineate the cause of an overactive bladder, blood tests may be performed along with a flow test and a scan of the bladder. Some patients undergo bladder inspection, or a cystoscopy, whilst others may go on to have urodynamic studies or pressure studies of the bladder. Treatment of an active bladder is stepwise, patients are advised on lifestyle modification and often given tablets to try and relax the bladder and reduce the spasm. If that fails they may be offered more invasive therapy such as Botox injections directly into the bladder muscle, they may be able to undergo nerve stimulation in order to relax the bladder and in very rare circumstances, surgery may be required.