What is Erectile dysfunction?

Erectile dysfunction, or ED, is the persistent inability to achieve or maintain an erection that is firm enough for sex. ED affects around 30 million men in the world and can be caused by a number of reasons including stress, depression and other mental health disorders.

ED can also be an early warning sign of more serious illnesses such as heart disease, diabetes and high blood pressure. Although living with ED can affect your relationships or weaken your self-esteem, the good news is that just about every case of ED is treatable!

For most men experiencing ED, oral medications are the first treatment option, utilizing prescription drugs such as Viagra, 2 Cialis, 3 or Levitra. These common medications known as PDE-5 inhibitors relax muscle cells in the penis, allowing an increase in blood flow.

However, about 30% of men require additional treatments beyond oral medications, and each option has varying degrees of success and reliability. Because choosing the right treatment can be a difficult decision offering a range of potential benefits and risks, talk to your doctor about which choice is best for you.


YOUR TREATMENT OPTIONS:

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Medication

Of all treatment options available, oral medications are the most effective, working in around 70%-80% of men in conjunction with sexual stimulation. Typically, pills need to be taken one hour before anticipated sexual activity and can last for up to four hours (~36 hours with daily use of Cialis). The dosage should not be taken more than once a day, and most oral medication can be affected by food.

Common Side Effects:

  • Headache, Facial Flushing, Stuffy Nose, Upset Stomach, Dizziness

Contraindication:

  • Cannot take with nitrates

Tell Your Doctor If:

  • If you have any history with a stroke, heart problems, high or low blood pressure

Vacuum Erection Device

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A vacuum erection device is a hollow plastic tube with a hand or battery-powered pump and a tension ring. The tube is placed over the penis, creating a low-pressure vacuum around the erectile tissue, allowing blood to flow into the penis. Once an erection is achieved, an elastic tension ring is placed at the base of the penis to confine the blood, keeping it hard for up to 30 minutes. If used properly, 75 out of 100 men can get achieve an erection with this method.

Patient Satisfaction:

  • 27%-94%

Most Common Side Effects:

  • Blocked ejaculation (up to 40%)
  • Penile numbness or coldness (5%)

Most Common Reason for Discontinuation:

  • Lack of spontaneity, unnatural erections, penile bruising, lack of efficiency

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Injections

Patients choosing injection therapy will receive medications inserted directly into the base or side of the penis. Common medications include Phentolamine, Alprostadil and Papaverine which stimulate an erection by improving blood flow into the penis. Typical erections last around 20-40 minutes and pain from the injection site is minor.

Patient Satisfaction:

  • 44%-94%

Most Common Side Effect:

  • Penile pain (up to 50%)
  • Prolonged erections (5%)
  • Penile fibrosis (2%)

Most Common Reason for Discontinuation:

  • Insufficient erections, bruising of penis, lack of spontaneity, dislike of injections


Penile Implant

Since the 1970s, penile implants have been used to treat ED, but are recommended only when all other options have been tried. The outpatient surgical procedure includes placing devices into both sides of the penis that are entirely contained within the body. To achieve an erection, squeeze and release the pump in the scrotum, controlling when and how long your erection lasts.

Patient Satisfaction:

  • 94%-98% for three-piece penile implants

Most Common Side Effect:

  • Post-operative genital pain (up to 53%)
  • Mechanical malfunction (4%-11%)
  • Infection (1%-3%)

Most Common Reasons for Discontinuation:

  • Repeat surgery due to mechanical malfunction