Q. Are erectile problems reversible when the cause has to do with diabetes?
A. Unfortunately, diabetes has multiple effects on sexual behavior and particularly the ability to achieve erections. Diabetes may interfere with erections in any of three ways:
- Diabetes can damage the blood supply to the penis. Damage to the blood supply results from early atherosclerosis (“hardening” of the arteries) and fibrosis of the small arteries of the penis.
- Diabetes can damage the nerve supply to the penis. This occurs when high blood sugar damages the nerve fibers, and impulses that promote erections do not get transmitted to their targets in the penis.
- Long-standing diabetes can alter the microstructure of the penis. This involves a loss of elasticity of the penis and fibrosis of the penis.
All of these changes are irreversible. However, some are treatable. In general, patients with diabetes have a mixture of these effects, so treatment for the erectile dysfunction is often very successful. If management with medications such as Viagra fails, the urologist can install a penile prosthesis; this typically produces excellent satisfaction and long-term durability.