What are the treatment options for erectile dysfunction?

Erectile dysfunction is a common disorder that affects men of all ages. It is a man’s inability to get and maintain an erection. There are many different causes of ED and in many cases there is more than one underlying cause. All a urologist needs is a physical exam and a few questions answered in order to diagnose erectile dysfunction in a patient.

Dr. Brian Hale - Urologist at Palm Harbor, FLFor urologists like Dr. Brian Hale, treatment for erectile dysfunction begins with trying three different medications. The medications are generally oral and easy to take. The urologist will monitor the results of the oral drugs with the patient. Very often, at least one of the oral drugs prescribed will resolve the issue. For these cases, the urologist will write a prescription for the drug and continue to monitor its effectiveness through routine appointments.

If the urologist and the patient are unable to find an oral medication that works effectively, there are other options to consider. One possibility is injection therapy. Small injections into the shaft of the penis are used to dilate the penile arteries, helping increase blood flow, causing an erection. For most men who do not see results with the oral medication, injection therapy is their next best option.

For many men, injection therapy can seem a bit overwhelming at first, maybe even frightening. But in reality, the injections are easy to administer and are relatively painless. The urologist and the patient will begin the injection therapy with a teaching session at the urologist’s office. The urologist may use an ultrasound to monitor the reaction of the blood vessels to the injection to help determine the right dosage for the patient. The patient is also taught how to administer the injection on his own.

Patients are generally pleased after they start injection therapy. The teaching session at the office helps the patient see that the injections are not painful and can easily be done at home. It is very rare that a patient cannot do the injection therapy himself. For those who did not respond positively to the oral drugs, injection therapy is an ideal treatment to produce the desired results and overcome the erectile dysfunction.

Treating erectile dysfunction is an important part of a patient’s well being, both personally and within his relationships. The urologists of the Advanced Urology Institute offer many options for treatment and remain committed to finding the best one for each patient. For more information, visit the Advanced Urology Institute website.

Talk With Your Doctor About Erectile Dysfunction

The first step in treating erectile dysfunction is talking to your doctor about it. Unfortunately, for many men this can be difficult as erectile dysfunction is often a sensitive subject for those experiencing it. However, the issue is far more common than most men realize. As Chelsea Ferrell , physician assistant, states, “Fifty percent of men over 50 have some degree of erectile dysfunction, so you do not have to be embarrassed to speak to your doctor about it.” Urologists and PAs discuss erectile dysfunction with patients on a daily basis.

Chelsie Ferrell, Physician Assistant at DeLand, FLUrologists can usually diagnose erectile dysfunction during the appointment by asking a few questions about medical history and having a conversation with the patient. Once diagnosed, urologists try to discuss erectile dysfunction with the patient by reassuring him that even in the most severe cases there are still plenty of treatment options available. Because there are so many options available, the decision really is up to the patient working with his urologist to decide the best treatment for a successful outcome in his case.

There are plenty of different treatments available for erectile dysfunction and, in many cases, if one does not work another will. The most common options are pills like Viagra and Cialis, or generic versions of these pills that offer the same effects at a lower price. Others prefer the vacuum erection device. This is a cylindrical pump that the penis goes into and works like a vacuum to draw blood to the area, with a band that goes around the base of the penis to keep the erection.

Many men respond to at least one of these treatments. However, for those who do not there are still plenty of options. The urologist may want to try injection therapy. Men can give themselves small, relatively pain-free injections of a treatment into the base of the penis that will stimulate an erection. If injection treatment does not help, then the urologist may suggest a penile prosthesis. An implant is surgically inserted into the penis attached to a pump in the scrotum that can be used to give the patient an erection. This treatment will correct the patient’s erectile dysfunction for life.

Talking to your doctor about an issue as common as erectile dysfunction does not have to be an uncomfortable experience. And with the many options available now to treat erectile dysfunction, the right option is just a conversation away. Chelsea Ferrell PA at the Advanced Urology Institute is one of the many friendly and intelligent professionals helping patients find their best treatment option. For more information, visit the Advanced Urology Institute website.

What Treatments Are Available For ED?

Erectile dysfunction is the inability to achieve or maintain an erection firm enough for sexual intercourse. It is not incidental to aging, though in reality it occurs mostly in men over the age of 40. The causes of erectile dysfunction are varied, and the first step is to establish whether it is caused by an underlying condition. Whatever the cause, however, there are various options when it comes to the treatment of erectile dysfunction.

1. Oral Medication (Pills)

Like many other medical conditions, erectile dysfunction can be treated effectively by taking medicine. Oral medicines for erectile dysfunction fall under a group called phosphodiesterase 5 (PDE 5) inhibitors. They work by preventing the functioning of the enzyme phosphodiesterase type 5 whose job is to control blood flow to the penile arteries. When the enzyme is not functioning, blood vessels relax, allowing blood to reach the penis, therefore causing an erection. The most common PDE 5 inhibitors are:

a. Sildenafil- commonly referred to as Viagra
b. Avanafil – also known as Stendra
c. Tadalafil – also known as Ciaris; and
d. Varednafil- also known as Levitra

Most of these medications are widely available. It is necessary, however, to consult with a urologist before taking any of them. A trained urologist should be able to assess a patient’s condition and advise whether oral medication is likely to work and if so, which of the available medicines is best suited to the patient’s case.

2. Penile implants

For some men, especially those with underlying conditions, oral medication does not work. They may have to resort to other treatment options and the most common of these is the penile implant. This involves a minor surgical procedure and the placing of an implant that causes an erection. There are two choices when it comes to the implant. There is the inflatable implant and the malleable/ semi-rigid implant. Both options have their advantages and disadvantages and the patient will decide based on his circumstances. Overall, however, both implant options report a success rate of over 90 percent.

3. Vascular reconstructive surgery.

Vascular reconstructive surgery involves reconstructing the arteries within the penis to increase blood flow. This last option is neither common nor popular. It is a very difficult, and therefore expensive, procedure. Additionally, it is not always successful and a patient might face the risk of relapse.

It is possible to treat erectile dysfunction. But the right treatment option must be sought for each individual case. It is recommended that anyone experiencing erectile dysfunction should see a urologist. The highly qualified and experienced urologists at Advanced Urology Institute can provide consultation, technology and treatment plans to help patients with erectile dysfunction. Want to find out more about erectile dysfunction? Visit the “Advanced Urology Institute” site.

Ways to Treat Erectile Dysfunction

If you suspect that you have erectile dysfunction, you need to talk to your doctor about it. Then you can work with the doctor to determine the underlying factor or cause of the condition. Actually, ED can only be effectively treated if what is causing it is known. In fact, you may find that your condition improves with only simple lifestyle changes, such as losing weight, quitting smoking or drinking less alcohol. And if it is a medication you’re taking that is causing the problem, your doctor may treat the condition by reducing the dosage or having you try another drug.The treatment options for ED include lifestyle changes, counseling, medications, penile injections, vacuum pumps and surgery.

1. Lifestyle changes

Making lifestyle changes can reduce the severity or improve erectile dysfunction. Some of the changes are:

a. Quitting smoking
b. Stopping or reducing alcohol consumption
c. Increasing physical activity or exercise
d. Cutting down body weight
e. Stopping the use of illegal drugs

2. Seeing a counselor

Your urologist may recommend that you see a counselor if your erectile dysfunction is worsened by psychological or emotional issues. In many cases, counselors require that you go with your partner to the counseling sessions so she can know how best to support you. And as you work on the anxiety and stress issues with your counselor, your urologist will be focused on treating any underlying physical issues. Usually only a handful of sessions with the counselor will be enough for you to overcome ED.

3. Medication

The first treatment that your urologist will offer to treat ED is oral pills. Common oral medications for ED include:

a. Sildenafil (Viagra)
b. Tadalafil (Cialis)
c. Vardenafil (Levitra or Staxyn)
d. Avanafil (Stendra).

These medicines work by relaxing your smooth muscles and increasing blood supply to the penis following sexual stimulation. You’ll be required to take them anywhere from 15 minutes to 36 hours before sex, depending on the particular drug your doctor has prescribed. Vardenafil (Staxyn) dissolves in the mouth, but the other pills are swallowed. However, you aren’t allowed to take any of these drugs more than once per day. The drugs are effective in about 80 percent of men who use them, although if you have an erection that lasts beyond 4 hours, you should seek emergency medical help.

You should not take these medicines as treatment for ED if you are already taking nitrates for a heart disorder. Since nitrates also relax and widen blood vessels, their combination with these drugs leads to a sudden reduction of your blood pressure, which may cause falling, fainting or dizziness and possible injuries. Likewise, if you are already taking drugs to treat enlarged prostate (BPH), inform your doctor about them. A combination of BPH medications called alpha-blockers with ED medicines also may result in sudden reduction of your blood pressure.

In case your erectile dysfunction is due to low testosterone levels, the urologist may prescribe testosterone. However, testosterone therapy won’t work for you if you have nerve or circulatory problems. So you must be very open with your urologist about your other medical problems before you are given any medications.

4. Penile injections

Injecting the penis with a drug called alprostadil can trigger a stronger and firmer erection. While oral medications are able to cause an erection after sexual stimulation, you can’t get an automatic erection with them. That’s why your doctor may at times opt for injecting a drug into the penis to ensure you achieve erection automatically even without sexual stimulation.

5. Vacuum constriction devices (pumps)

Vacuum pumps pull blood into the penis, resulting in an erection. A typical vacuum device is an external pump supplied with a band that you can use to achieve and maintain an erection. According to several studies, up to 50-80 percent of men who have used vacuum erection devices are pleased with the results.

A vacuum device has three components:

a. A plastic tube (cylinder), which you place toward the end of your penis.
b. A pump, which drives out air from the tube in order to create a vacuum.
c. An elastic ring (band), which you place on the cylinder, on the other end applied to your body, and then move it from the tube to the penis in order to maintain erection.

To use the vacuum erection device, you place the pump over your penis and pump out air from the tube (cylinder) to create a vacuum. The vacuum then pulls blood into the penis’ shaft and makes the penis longer and firmer. Once the penis is erect, and with the help of a lubricant, you slide the retaining band downward onto the lower end of your penis. You also remove the pump once you have released the vacuum.

The elastic ring sustains the erection by stopping blood from moving back into the body during intercourse. So you can only attempt intercourse with the elastic ring in place. And the ring can be left in place for about 30 minutes to enable successful intercourse.

6. Penile prosthesis (Penile implant surgery)

Another option for treating ED is penile prosthesis in which your urologist performs an operation to implant either a malleable (bendable) device or inflatable device into your penis. A penile implant surgery is preferred when you have an obvious medical condition that is causing the ED and the urologist is sure that your condition won’t resolve naturally or with medications.

Usually, the simplest form of penile prosthesis is surgical implantation of malleable rods inside the erection chambers of your penis. Once implanted, the rods ensure that your penis is maintained in semi-rigid state and just requires lifting or adjusting to erect position for sexual intercourse. Malleable rods are a good option if you’ve had spinal injury or have limited hand strength.

Alternatively, your doctor may go for a hydraulic, inflatable implant. With this prosthesis, you can choose to get an erection when you need to. Inflatable implants increase the size of the penis through a pump that’s located in the scrotum. The advantage of an inflatable implant over malleable rods is that the erection is more natural and easier to conceal than one achieved with malleable rods.

Penile implant surgery takes about one hour to complete and is usually performed in an outpatient setting. Following penile implant surgery, you’ll be able to leave the hospital the same day after surgery and can resume sexual intercourse 4-6 weeks after the procedure.

7. Artery reconstruction (Vascular reconstructive surgery)

Artery reconstruction is often a last resort treatment for ED because the procedure is costly, technically difficult and does not usually work. But the aim of the procedure, when recommended, is to boost blood flow in your penis and help you achieve an erection. During the operation, the urologist transfers an artery in another part of your body (usually from a muscle in the belly) to one in your penis, creating a path for blood to move around the blocked (affected) area. The procedure is only rarely considered, but may be an option for men younger than 30 who have ED because of injuries to their penis or the area around it.
Want to find out more about erectile dysfunction? Visit the “Advanced Urology Institute” site.

Are Medications Effective in Treating Erectile Dysfunction


Erectile dysfunction occurs to some degree in about 50 percent of men 40-70 years old. But only 10 percent of men report a total inability to have erections. For 70 percent of men with ED, taking an erectile dysfunction drug can produce an erection sufficient for intercourse. The drugs typically improve the supply of blood to the penis and, together with sexual stimulation, they produce an erection that is hard enough to begin and complete intercourse.

What ED pills are available?

The first ED drug commonly offered is sildenafil (Viagra). It has been on the market for the longest time and its side effects and the foods it interacts with are well known. Other ED drugs available in the U.S. are tadalafil (Cialis), avanafil (Stendra) and vardenafil (Levitra). Another option is Staxyn, the fast-dissolving form of Levitra that is placed under the tongue.

How well do these drugs work?

In those who are otherwise healthy, ED drugs produce an erection sufficient for sexual intercourse in at least 70 percent of men. Although the results vary slightly with each person, 70-80 percent of men will respond well to these medications. In fact, the majority of men with ED are pleased to use these medications. And while there are some who may not have the desired effect from any of these drugs, including men with damaged arteries or nerves after prostate surgery, cardiovascular disease, or diabetes, a larger number will find them quite effective.

How quickly do the pills work?

The pills may not work if they are not used correctly. These drugs are not an on-and-off switch for erections. So they won’t work well if there is no sexual stimulation. After taking the drugs, it is important for a man to be with his sexual partner and have foreplay. Likewise, Viagra and Levitra do not work if taken after a meal and must be taken before eating. But Stendra and Cialis do not interact with food and can be taken after a meal. When used properly, it takes about 15-60 minutes for the pills to start working.

Which drug works best?

There is no specific ED drug that is the best. Studies have shown that all ED pills have similar efficacy and safety. So the best drug depends on the man’s body chemistry, lifestyle and needs. That is why men should consider their and their partners’ preferences and the cost of their preferred medications. For instance, they may consider how spontaneous their partners are when it comes to sexual activity.

Nevertheless, studies have shown that about 52 percent of men with ED prefer tadalafil (Cialis), 28 percent prefer sildenafil (Viagra) and about 20 percent prefer vardenafil (Levitra). Tadalafil is more popular because it offers a 36-hour window of opportunity to have an erection while the other pills offer a much shorter period.

What are the alternatives to ED drugs?

For men not satisfied with the pills or who have conditions that make these drugs ineffective, shockwave lithotripsy is a great alternative to explore. During this treatment, waves are delivered to the penis to create or improve vascularity. Even if shockwave lithotripsy does not work, the urologist may request a test to measure the rate of blood flow to the penis. The test can help the doctor determine if there are underlying issues that ought to be addressed.

Even though ED drugs are generally safe, they should not be taken by men with certain conditions. For example, men with heart disease should not take these drugs. ED patients should always tell their doctors about all their health issues and the medications they are taking during their consultations. With this information, doctors can recommend the right pills or treatment for each patient. For more information on treatment of erectile dysfunction, visit the “Advanced Urology Institute” site.

Penile Implants for Erection Problems

You are finding it difficult to have an erection that is sufficient for sexual intercourse. So you make an appointment to see a urologist. The urologist will take your medical history, do a physical exam and run a few tests to establish the underlying cause. And from the results of the evaluations, the urologist will be able to determine the right treatment for your problem. The treatment may involve taking medications, penile injections, vacuum erection devices, penile implant or reconstructive surgery.

Why should you see a specialist in penile implants?

As you visit a urologist to help resolve your erectile dysfunction, you also should consider seeing one with specialization in penile implants. Why? Because in some cases erectile dysfunction is not effectively resolved through medications, vacuum erection devices or penile injections and you may need a penile implant. Also patients treated with penile implants are significantly more satisfied with their treatment than those treated with erectile dysfunction medication or other options. There is 98 percent satisfaction with penile implants, while 95 percent of partners would recommend it to someone else.

While penile implants are usually a third line of treatment for ED and is often reserved for severe cases of the condition, it is a good first option for men who don’t want to take medication, those who can’t take ED medications due to contraindication, and for those for whom treatments such as injections and vacuum devices aren’t ideal for their lifestyle.

However, not all urologists perform the procedure and some doctors may not even offer it as a treatment option. If that is determined to be the best option for your ED, then you may need to find a urologist with experience doing penile implants.

What is a penile implant?

A penile implant (also called penile prosthesis) is a mechanical device inserted in the body and allows fluid to be pumped into the penis. Currently the most effective and most popular penile implant is the three-piece inflatable device — a self-contained, fluid-filled system comprising of a reservoir inserted in the abdomen, two cylinders located in the penis and a pump situated in the scrotum.

Designed to mimic both the appearance and functionality of a naturally erect penis, a penile implant is custom-fitted to the body during an outpatient procedure that lasts one hour and thereafter is used to achieve an adequate erection for sexual intercourse. The penile implant mimics the normal penis to the extent that if a man doesn’t tell his girlfriend or wife about it, she is unlikely to know that he has it. The recovery period after penile implant surgery is 4-6 weeks and a man can begin to enjoy sex fully after recovery.

How does a penile implant work?

You simply squeeze and release the pump implanted in your scrotum to have the fluid move into the cylinders located in the penis. The movement of fluid into the cylinders helps you to achieve an erection. To deflate the device, you press the deactivation button found on the pump and the fluid will move back. When inflated, the three-piece inflatable implant acts and feels like a natural erection. But it still feels quite natural and comfortable when flaccid. Likewise, your sensitivity and ability to ejaculate is not diminished by the implant.

How long does a penile implant last?

Penile implants last for a long time. In a majority of men, it lasts for more than 5 years after it has been implanted. Actually, in 70 percent of men, penile implants remain functional and working for up to 10 years after implantation, although some patients retain working implants for up to 20 years after implantation. So the need to replace penile implants primarily depends on the age of the patient. If you are slightly older than 18 at implantation, you are certainly going to replace it a couple of times. But if you get the implant when your are 60-70 years old, you may only need one replacement.

At Advanced Urology Institute, we are proud of our track record in managing erectile dysfunction, particularly with the results we have achieved with prosthetic and reconstructive procedures. We perform several penile implant procedures annually and have managed to continually get excellent results. We perform the procedure using small incisions and end up with cosmetically remarkable implants with complete concealment of the components of the device.

We have performed the inflatable penile prosthesis so routinely that we have perfected our skills in it and can always guarantee the best possible outcomes for all our patients. For additional information on penile prosthesis and other treatment options for ED, visit the “Advanced Urology Institute” site.

Erectile Dysfunction Diagnosis and Treatment

Erectile dysfunction (ED), also called impotence, is a man’s inability to achieve or maintain an erection that’s hard or firm enough for sexual intercourse. Occasional ED is quite common among men, particularly during times of severe fatigue or stress. However, frequent erectile dysfunction can be a signal of serious health, relationship or emotional problems and requires treatment.

Major symptoms of erectile dysfunction include:

  1. Problem getting an erection.
  2. Diminished interest in sex.
  3. Difficulty maintaining a firm enough erection for sexual intercourse.

It’s important to speak with your doctor if you are experiencing any of these symptoms, particularly if they last 2 or more months. The doctor will determine if there is an underlying condition to your ED and whether or not treatment is necessary.

Medical history and physical exam

At Advanced Urology Institute, we usually begin with a medical history and physical exam so we can find the reasons for your ED. Erectile dysfunction can be due to stress, fatigue, anxiety, low testosterone, physical problems or other factors. When we take your medical history, we will ask you questions about your health and the symptoms you are experiencing. Then we perform tests to determine whether your symptoms have an underlying cause.

You should expect a physical examination where the doctor listens to your lungs and heart, measures your blood pressure and examines your penis and testicles. We also frequently recommend a rectal exam for checking your prostate. Likewise, urine or blood tests may be necessary to rule out conditions with similar symptoms.

Who needs treatment?

When making a diagnosis for erectile dysfunction, problems such as premature ejaculation and low libido are not considered. We basically focus on your failure to have or maintain a steady erection. Since most men have ED at one point or another in their lives, the most useful factor when determining whether or not to offer treatment is the frequency of your problem. From a medical standpoint, an erectile dysfunction occurring as often as 20 percent of the time isn’t considered a major concern. However, ED that occurs 50 percent or more of the time is likely to have an underlying psychological or physical cause and warrants treatment.

ED medications

For most men, the treatments offered for erectile dysfunction are quite similar. In most cases successful treatment depends on effective treatment of the underlying causes. At times it may even be necessary to use a combination of treatments. At Advanced Urology Institute, we often begin with medications, giving drugs such as Cialis (tadalafil), Stendra (avanafil), Caverject (alprostadil), Viagra (sildenafil), Levitra (verdenafil) or Androderm (testosterone). These drugs increase the blood flow in the penis and will help you to achieve an erection. The fact that some of these drugs now have generic forms means prices have gone down and most men can afford to use them when appropriate.

Pumps and injections

In some cases, treatment for erectile dysfunction may involve the use of vacuum constriction devices (erection pumps). These are mechanical or automatic devices that help men to achieve erection by increasing blood flow to the penis. Basically, an erection pump consists of a cylinder with a pump attached directly to the end of the penis. After the pump has made the penis bigger, a constriction band or ring is attached to the other end of the penis to keep the erection comfortably in place for at least 30 minutes. The main advantage of these devices is that no invasive or surgical procedures are involved. When it’s appropriate, we recommend these devices for our patients and make arrangements so that they are ordered and sent to them.

For some men with erectile dysfunction, we may recommend penile injections. It’s often amusing talking about penile injections with men, but they are very effective in treating ED. With a sharp needle that’s too small to cause much discomfort, medications such as papaverine hydrochloride, prostaglandin E-1 or phentolamine are injected into the penis tissue to stimulate an erection. When used, papaverine injection relaxes muscles of the arterial wall, dilates the vessels and increases blood flow; phentolamine blocks nerve signals for muscle contractions and promotes muscle relaxation; while prostaglandin E-1 relaxes penile muscles resulting in an erection. Once we prescribe any of these penile injections, we show you how the injection is done — the process is simple, not painful, and up to 90 percent of the patients are able to do it on their own after it’s explained to them.

Surgical treatment of erectile dysfunction

If these options don’t work, then we may recommend surgical treatment of erectile dysfunction. Surgery can be used to implant a prosthetic device into the penis that causes an erection; reconstruct penile arteries to increase blood flow and facilitate an erection; or block off the veins in the penis to allow blood to leave the penis, which helps in maintaining an erection. At Advanced Urology Institute, we usually discuss surgery as an option for treating ED with our patients before recommending it to them. We do a lot of penile implants and penile reconstruction operations and offer several other treatments for erectile dysfunction.

Is erectile dysfunction affecting your relationship? At AUI, we offer several effective treatments for the condition, including medications, pumps, penile injections and surgery. Talk with us about your condition and find help in getting it effectively treated. We are committed to providing treatment that restores sexual health and satisfaction to men with erectile dysfunction. For more information on how we treat ED, visit the “Advanced Urology Institute’” site

The Effectiveness of Erectile Dysfunction Treatments

Worried about your inability to get or maintain an erection? Stop worrying and visit your doctor for an open and honest chat. A urologist can help you find safe and effective treatment of erectile dysfunction that will enable you to approach any future dates with your partner with confidence. Urologists are experts in treating erectile dysfunction and other genitourinary issues, so do not be anxious about such a visit. In fact, you will be surprised to find that your doctor is probably seeing up to a half dozen men with ED every week.

Oral ED Medications

The first choice of treatment for ED is usually oral medications called phosphodiesterase inhibitors type 5 (PDEi-5). These drugs include the first-generation agents such as sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis), together with second-generation agents like mirodenafil (Mvix), iodenafil (Helleva), udenafil (Zydena) and avanafil (Stendra). With the drugs providing a normal, natural erection in 80-95 percent of men as long as there is sexual stimulation, they are the best option for many men with ED. They also deliver high efficacy rates and favorable safety levels.

Transurethral and Intracavernosal Injections

If you are unresponsive to oral drugs, your doctor will review your treatment and consider other options. The urologist may consider a transurethral injection with a drug called alprostadil. The doctor may go for this option if your penile nerves have been compromised and you need to bypass the neurological pathways responsible for an erection. Another option may be an intracavernous injection of papaverine, phentolamine, PGE1 or vasoactive intestinal peptide (VIP). The injections are a good treatment choice with 91-96 percent success rates and proven safety. These drugs may be combined for better efficacy.

Vacuum Constriction Devices

Vacuum erection devices also may be considered. But these are commonly offered to elderly patients who may only want occasional sexual intercourse. Younger men do not like these devices because of the unnatural feeling of the erections and the mechanical procedure necessary to produce the erections. You should discuss this option with your doctor and find out if the devices are ideal for you.

Surgical Therapies

When medical therapies fail, your urologist may recommend surgery. Surgical procedures are often the last option because of the cost, non-reversibility and invasiveness involved. There are two kinds of surgery for men with ED: penile prosthesis and penile revascularization. In penile prosthesis, the urologist inserts an inflatable or semi-rigid implant into the penis tissue. The success rate of penile prosthesis is 97 percent, but the implant must be replaced every 8-15 years. Penile revascularization is a surgical procedure to repair either venous ligation or arterial stenosis. Explore surgery with your doctor if the other options fail to work for you, but be sure to understand what is involved before you make a decision.

Non-Specific Interventions

Erectile dysfunction treatments may be accompanied by other interventions. For instance, psychotherapy is a noninvasive and highly effective intervention that is often combined with other therapies for a better success rate. Likewise, your urologist may recommend lifestyle modifications, such as increased physical activity, dietary changes, moderate alcohol consumption or a decision to stop smoking in order to improve your ED symptoms and minimize cardiovascular risk. If tests show that you have low testosterone, your doctor may recommend testosterone replacement therapy before you use ED-specific medications. If you are a younger, healthier man, testosterone therapy may just be what you need for enhanced sexual desire and harder erections.

At Advanced Urology Institute, we have established a multidisciplinary, compassionate and patient-centered approach to the treatment of erectile dysfunction. We prioritize the needs and expectations of our patients during treatment, educating them and providing a supportive environment that ensures shared decision-making. We also conduct meticulous follow-ups to identify any changes in the relationships, health and emotional status of our patients to optimize the efficacy of our treatments. If you are experiencing bothersome and embarrassing ED, visit one of our urologists for help. Get more information on the treatment of erectile dysfunction at the “Advanced Urology Institute” site.

What is an Erectile Dysfunction? with Dr. James E. Renehan

Erectile dysfunction (ED) is a man’s inability or difficulty to get or keep erections that are firm enough to enable sexual intercourse.

While occasional ED is very common in men, particularly during times of stress, depression or fatigue, frequent ED can really ruin a man’s life. For instance, some men with erectile dysfunction may avoid contact with their partners for fear that they will have trouble satisfying them sexually in the bedroom while others may get into a complete emotional and psychological meltdown.

Forms of erectile dysfunction

According to Dr. James E. Renehan of Advanced Urology Institute, erectile dysfunction can take a variety of forms. For example, some men may be unable to get an erection under any circumstance, while other men with ED may occasionally get an erection. In other men, getting an erection is possible but the erections are not strong enough for satisfying sexual intercourse.

“Erectile dysfunction does not mean that you are infertile,” says Dr. Renehan. “In fact, the majority of the men having difficulties with getting an erection are still quite capable of achieving an orgasm and getting children. ED just means that you cannot consistently get or sustain an erection.”

What are the symptoms of erectile dysfunction?

You could be suffering from ED if you frequently have:

  1. Difficulty getting an erection.
  2. Trouble sustaining an erection throughout sexual intercourse or during sexual activities.
  3. Diminished interest in sex.

However, there are also a number of factors related to erectile dysfunction, such as:

  1. Premature ejaculation.
  2. Difficulty achieving orgasm even after ample stimulation (anorgasmia).
  3. Delayed ejaculation.

Experiencing such symptoms for 2 or more months may indicate that you have erectile dysfunction. So it is important to speak with your urologist to determine if you have a sexual disorder.

“Men should know that erectile dysfunction is not in the head,” says Dr. Renehan. “You will not simply get an erection by stimulation, as 80 percent of all cases of ED are usually caused by treatable physical disorders, such as high blood pressure, high cholesterol or diabetes. So make sure you visit your doctor for advice.”

Causes of erectile dysfunction

Erectile dysfunction may have several possible causes, including both physical disorders and emotional problems. The most common causes are:

  1. Diabetes
  2. Obesity (being overweight)
  3. Smoking, alcohol use or drug abuse
  4. Hypertension
  5. Cardiovascular disease
  6. Hyperlipidemia
  7. Injuries
  8. Stress, anxiety or relationship problems
  9. Damage from surgery or cancer treatment
  10. Increased age

Because there are many possible causes of erectile dysfunction, it is important to work with a urologist so that any underlying medical conditions are identified and treated.

Diagnosis of erectile dysfunction

When you visit your urologist, you will be asked questions related to your symptoms, health history, emotional and physical problems. You also should expect a physical examination in which the doctor will listen to your lungs and heart, examine your penis and testicles and measure your blood pressure. The doctor may order various tests to determine whether you have an underlying disorder, such as blood and urine tests. A rectal examination may be requested to check your prostate.

Treatment of erectile dysfunction

The treatment chosen by your doctor will depend on the type of symptoms and any underlying causes for the dysfunction. At times, a combination of treatments may be necessary. The most common treatments for ED include:

  1. Medications: The doctor may prescribe medications to improve blood flow to the penis and improve ED symptoms. The drugs commonly indicated include Alprostadil (Caverject), Avanafil (Stendra), Sildenafil (Viagra), Tadalafil (Cialis), Testosterone (Androderm) and Vardenafil (Levitra).
  2. Talk Therapy: If it is established that the erectile dysfunction is caused by psychological factors such as stress, depression, anxiety or post-traumatic stress disorder, the urologist may recommend that you see a therapist. Working with the therapist, you will attend several sessions in which you will be helped to recover from stress, anxiety, subconscious conflict or negative feelings around sex. A relationship counselor also may be called upon if the ED is affecting your relationship.
  3. Alternative Treatments: Treatments such as prostatic massage, acupuncture, yoga and pelvic floor exercises also may improve your condition. Likewise, lifestyle and diet changes, such as regular exercise, losing weight, lowering your blood pressure and avoiding cigarettes and alcohol can be recommended to help you overcome erectile dysfunction.
  4. Surgery: When medications and exercises fail to work, the urologist may perform a surgery to correct any problems in the penis or to add a penile implant. Penile implants help to generate spontaneous and controlled erections.

Erectile dysfunction is treatable

Most cases of erectile dysfunction are treatable. At Advanced Urology Institute, we have helped thousands of men to improve their symptoms and regain their confidence through compassionate, multidisciplinary, patient-centered treatment approaches. Depending on your condition, we will administer the right medications or treatments to ensure that you achieve an erection and be able to have satisfying sexual intercourse. Come and discuss your symptoms with us so we can fix your problem. For more information on help with erectile dysfunction, visit the “Advanced Urology Institute” site.

New Treatment Options for Erectile Dysfunction

Statistically, 50 percent of all men experience erectile dysfunction (ED) at some point of their life, with the risk of ED increasing with age. Roughly 30 million men in the United States suffer from ED, a condition that causes frustration and the breakdown of marriages and self-confidence.

Evolution of Erectile Dysfunction Treatments

Over the years, the medical management of erectile dysfunction has evolved greatly. For instance, before oral phosphodiesterase inhibitors (PDESi) like Cialis, Standra, Viagra, Levitra and related medications were introduced, doctors could administer one of only two effective treatments for erectile dysfunction: surgical penile revascularization and implantation of a penile prosthesis.

The emergence of Viagra and related oral drugs for ED ushered in a new age of non-invasive treatment of the condition. These drugs relax the muscles in the penis and increase blood flow, allowing patients to have an erection. However, while these drugs are helpful for many men, they are not safe for men with high blood pressure, severe liver disease, kidney disease, or who take nitrate drugs. The drugs also come with side effects such as a runny or stuffy nose, dizziness, fainting and blurred vision. Because of these limitations, doctors have continuously looked for new treatment options for erectile dysfunction.

New Treatment Options

New treatment options for ED include:

  1. Injection therapy: Drugs such as alprostadil (sold under the names Edex, Caverject and Prostin VR) and the suppository-form of alprostadil (sold as MUSE) are currently available to patients. Alprostadil causes expansion of blood vessels and increased blood flow to the penis, enabling patients to get erections.
  2. Extracorporeal shock-wave therapy (ESWT): Also called acoustical wave therapy or linear shockwave therapy, ESWT uses high-frequency acoustical waves for treatment of the root cause of ED. During treatment, the waves are used to open and repair blood vessels in the penis. The therapy improves blood flow in the penis by creating new blood vessels or rejuvenating existing ones, which in turn increases the patient’s ability to get an erection.
  3. Melanocortin activators: These drugs stimulate erection by acting through the central nervous system. For instance, the drug PT-141 is effective in stimulating erection when given through the nose to men with mild-to-moderate non-medical (emotional or psychological) erectile dysfunction.
  4. Topiglan: This is a cream that is applied to the penis. Topiglan contains alprostadil, the same drug that is injected or applied as suppository by men with ED.
  5. Uprima (apomorphine): Working to stimulate the secretion of the brain chemical dopamine, Uprima heightens sexual interest and increases sensations. It comes in tablet form that easily dissolves under the tongue. However, because of its major side effects of nausea and vomiting, research is still going on to find a nasal spray alternative that causes less nausea but is equally effective.
  6. Gene therapy: The therapy delivers genes that help generate proteins or products that can replace those that are not functioning well in the penile tissues of men with ED. While experimental use of gene therapy has reported tremendous success, regulatory approval and the public’s acceptance of the therapy may still take some time.

If you are suffering from erectile dysfunction, consider your options carefully. Talk to your urologist openly. Effective treatment of ED can improve your quality of life, ability to maintain intimate relationships and boost your self-esteem. At Advanced Urology Institute, we are always improving our range of treatment options to give the very best to our patients. When you visit our urology center in Florida, you can be sure that you will have a broad range of treatment options, including the very latest, for erectile dysfunction. For more information on diagnosis and treatment of erectile dysfunction, visit the “Advanced Urology Institute” site.