Penile Implants for Erection Problems – Dr. Rishi Modh

My name is Rishi Modh, I am a board-certified urologist with Advanced Urology Institute.

So I think when you go see a urologist about erectile dysfunction, you need to see a urologist who specializes in implants as well. Not all urologists perform penile implants so they may not even offer it as an option for you. A penile implant is an outpatient procedure with a small incision and a fast recovery. It’s a mechanical device that’s placed inside your body that allows you to pump fluid into the penis in order to give you a great erection. Ninety-five percent (95%) of men are extremely happy with their penile implant and ninety-five percent (95) of partners would recommend it to someone else to have a surgery done.

Do You Treat People With ED

Well, yes—every day. At Advanced Urology Institute, we treat men with erectile dysfunction (ED) and achieve great results for our patients. Erectile dysfunction is a big issue for men today, regardless of their age. Up to half of all men experience some form of ED in their lifetime, with roughly 10% of men over 40 suffering severe forms of impotence.

What is erectile dysfunction?

Also called impotence, erectile dysfunction is the inability to regularly get or maintain an erection for satisfying sex. In general, an occasional problem should not be a cause for concern. In fact, it is normal to have trouble getting or keeping an erection for up to 20% of sexual encounters. But frequent trouble getting an erection indicates a medical problem. With ED, successful erections either become the exception more than the rule or they never happen.

Treating People with Erectile DysfunctionSome of the causes of ED include:

  • Alcohol use, illicit drug use, or smoking
  • Medications, such as for high blood pressure
  • Diabetes
  • High cholesterol
  • Heart disease
  • Obesity
  • Blocked blood vessels
  • Scar tissue inside the penis
  • Sleep disorders
  • Metabolic syndrome
  • Anxiety, stress, or depression
  • Emotional or relationship issues

Risk factors for erectile dysfunction include advanced age, diabetes, obesity, depression, cardiovascular disease, high blood pressure, low testosterone, high cholesterol and smoking.

What does treatment for ED involve?

Erectile dysfunction is a treatable condition. At Advanced Urology Institute, we offer several treatment options, generally beginning with the least invasive approach. We also give lifestyle advice that may help with overcoming the condition.

For instance, if your ED is due to inactivity, obesity, metabolic syndrome, high blood pressure or cardiovascular disease, we may recommend you engage in regular aerobic exercise to help reduce the symptoms. We may also recommend you quit smoking, minimize your alcohol intake and follow a healthy diet.

Treatments for ED include:

1. Phosphodiesterase type-5 (PDE5) inhibitors

PDE-5 medications are typically the first line of treatment we recommend for men with ED. They include Stendra (avanafil), Viagra (sildenafil), Cialis (tadalafil), and Levitra or Staxyn (vardenafil).

These oral medications work in a similar manner to boost the level of cGMP—a natural chemical in the body that promotes the widening of blood vessels following sexual arousal. In turn, more blood reaches the penis.

At the same time, these medicines enhance the relaxation of muscles of the penis in response to stimulation, hence increasing blood flow to the penis and allowing an erection.

2. Creams and injections

Sometimes we prescribe a topical Alprostadil cream as an alternative to the oral medications. The cream comes with a plunger and is applied to the tip of the penis and the surrounding skin 5-30 minutes before having sex.

At other times, we may prescribe penile injections as a treatment for ED. That is, we teach you how to inject a medicine at the base of your penis 5-20 minutes before sexual intercourse. After the injection, there will be increased blood flow to your penis and an erection will develop within 15 minutes.

3. Penis pumps (vacuum devices)

A penis pump (vacuum erection pump) is a tube that fits over the penis. A plastic container is placed over the penis and the pump draws air from the container to create a vacuum. The change in air pressure when the device is used causes blood to be drawn into the penis and triggers an erection.

Once the vacuum creates an erection, the retaining band is slid down the lower end of the penis and the pump is removed. An erection will typically last long enough for intercourse but the penis may be cold to the touch, and the rubber band may restrict ejaculation.

4. Penile implant (surgery)

We generally recommend surgery only when all other treatment options are not successful or not well tolerated. If that is the case, a penile implant (prosthesis) may help in achieving erections.

A penile implant is a medical device surgically placed into a penis to mimic the look and performance of a natural erection. The prosthesis involves an inflatable rod inserted in the middle of the penis, with a pump hidden in the scrotum. The pump is used to inflate the rod, which in turn causes an erection.

Penis pumps are custom-fit to your anatomy in a procedure that is performed carefully to ensure that the sensitivity of the penis and your ability to ejaculate are not adversely affected, allowing you to have a normal orgasm and great sexual encounters.

At Advanced Urology Institute, we recognize that erectile dysfunction is a common but very sensitive issue. That is why we provide a compassionate, patient-friendly approach to ED treatment to help men tackle it as soon as it starts. And because ED may also be a sign of a more serious medical condition, we encourage you to speak with a urologist as soon as possible to help you address the underlying condition and find the best treatment option.

Remember, the sooner you speak with your doctor about ED, the sooner you can go back to enjoying physical intimacy with your significant other. For more information about the diagnosis and treatment of erectile dysfunction, visit the Advanced Urology Institute website.

Are Medications Effective in Treating Erectile Dysfunction – Dr. Yaser Bassel

My name is Yaser Bassel, I am a board-certified urologist with Advanced Urology Institute.

I would say the vast majority of them, especially if they have not tried medications prior to them being seen in our office, probably 70-80 percent of those men will at least have a response to the medication oftentimes enough to basically be satisfactory to the patient or make them pleased with the way the medication is working. So most of them would actually get a good response to the medication.

Are there other treatment options for ED?

As far as what we have available to us now and what’s on the forefront, [for] those patients that do not want medication there are some newer technologies that are available that utilize shockwave energy to try and create newer vascularity in order to get a better response for that medication and that is something that’s basically come out over the past couple of years that we are starting to utilize in our practice. For those that do not respond to medication and still want to have treatment, the next step oftentimes [is] performing a test called a Penile Doppler where we will inject the penis with a vasoactive medication which will then initiate an erection so that we can measure blood flow and also measure for a venous leak which are two reasons why patients can have issues with erectile dysfunction.

If you are in need of a consultation or have any questions, visit us at our Tampa, FL office or call us at (813) 749-0820.

Erectile Dysfunction Overview

Erectile dysfunction (male impotence) is a man’s inability to achieve or maintain an erection with enough firmness to have satisfying sex. Occasional erectile dysfunction (ED) is common and many men experience it when undergoing some form of stress. But frequent ED can be a sign of serious health, emotional or relationship problems that require the attention of a professional.

How common is erectile dysfunction?

Roughly 30 million men in the United States have problems achieving or maintaining an erection. The frequency of ED increases with age, affecting only 5-40% of men in their 40’s and up to 50-80% of men over 70 years. However, while the risk of ED increases with age, the condition is not an inevitable consequence of aging. Good health is the key to a lifetime of good sexual function.

Who is at risk of erectile dysfunction?

Dr. James Renehan of Tallahassee, FLApart from occurring frequently among the elderly, ED is often a consequence of poor emotional and physical health. It is common in men with high cholesterol, diabetes, obesity, cardiovascular disease, hypertension, prostate disease, anxiety, damage from surgery or cancer, injuries, stress, depression, performance anxiety, relationship problems, alcohol use, smoking, and drug use. Typically, ED is caused by vascular disease (such as atherosclerosis) that prevents blood supply to the penis, a neurological disorder (like multiple sclerosis) that cuts transmission of nerve impulses to the penis, chronic medical disorders such as Peyronie’s disease, stroke and diabetes, trauma, and operations for bladder, colon and prostate cancer which may affect blood supply to the penis. These risk factors may work singly or in combination.

How is erectile dysfunction treated?

When you visit a urologist, the first step in the diagnosis of the problem is a thorough sexual, medical and psychosocial history. Physical examination with emphasis on the genitourinary, neurologic and vascular systems is performed. From the information gathered, the urologist may request hormone tests (testosterone, luteinizing hormone, and thyroid – stimulating hormone, prolactin and serum hormone-binding globulin), urinalysis, PSA (prostate-specific antigen), lipid profile, and serum chemistry. Functional tests such as prostaglandin E1 injection, formal neurologic testing, nocturnal penile tumescence testing and biothesiometry may be requested, together with imaging studies such as transrectal, testes and penile ultrasonography and angiography.

If erectile dysfunction is diagnosed, the doctor may recommend treatment depending on the cause and severity of the condition. For instance, the urologist may recommend sexual counseling when no organic causes can be established for the problem. Oral medications such as sildenafil, vardenafil, tadalafil or avanafil may be offered to relieve the problem. But for those not responding to oral medicines, the urologist may inject, implant or direct the topical application of drugs such as alprostadil, phentolamine or papaverine. In some cases, an external vacuum or constriction device may be recommended while for other patients hormone replacement therapy may be used to treat severe hypogonadism (lower-than-normal testosterone). Alternatively, the urologist may opt for surgery through procedures such as revascularization, placement of penile implant or surgical correction of venous outflow.

How is erectile dysfunction prevented?

  • Eat a healthy, balanced diet that avoids saturated fats and increases the intake of vegetables, fruits and whole grains.
  • Reduce cholesterol levels through exercise, medication and diet.
  • Maintain a healthy body weight.
  • Exercise regularly.
  • Seek prompt treatment or professional help for conditions such as stress, depression, hypertension, heart disease and diabetes.

At Advanced Urology Institute, we recognize that effective treatment of erectile dysfunction involves a proper determination of the underlying cause and a frank discussion of both medical and non-medical options. This is why we have assembled an accomplished team of physicians, state-of-the-art facilities and a patient-centered system that responds to the unique needs of each patient. If you are experiencing a urological problem, make an appointment today. For more information, visit the Advanced Urology Institute website.

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.

Discussing a Sensitive Topic: Erectile Dysfunction

Erectile Dysfunction, also called ED, is the inability for a man to get or maintain an erection firm enough for sexual activity. It is a very personal and sensitive issue that can be difficult to talk about. Although ED is a common issue that affects many men, it can still cause feelings of embarrassment and shame. This makes open conversations, even with a trusted urologist, difficult in some cases.

Dr. Billy Vanasupa of St Augustine, FLA urologist is a doctor who specializes in the urinary tract and male reproductive system. They are the doctor a patient will most likely to go to about his ED. Urologists see countless cases of ED on a regular basis, and to them it is not a major issue at all. However, good urologists understand that ED can be an embarrassing issue for their patients and they immediately begin their visits by creating a comfortable environment where doctor and patient feel at ease discussing it.

One such urologist who works to create a comfortable environment is Dr. Billy Vanasupa. When talking about his approach with patients who see him for ED, Dr. Vanasupa says, “I always try to make my visits light, make some jokes here and there, and make them feel comfortable.” His goal is to make his patients laugh so they are less nervous and feel they can easily talk to him. Dr. Vanasupa removes the stigma of ED so he and his patient can openly discuss this sensitive topic.

Once everyone is comfortable discussing the topic, the urologist will ask background questions like whether the ED occurred slowly or abruptly. The patient will be asked if he has tried any medications. The doctor’s questions are to help determine root causes for the issue and will include asking about diet, alcohol and drug use, and stress factors. Finding possible causes for ED is an important first step in treating it.

The urologist and patient will discuss best treatment options for ED. In many cases, oral medication, possibly along with some minor lifestyle adjustments, will fix the issue and allow healthy men to return to their normal sexual activity. For some men, oral medication does not help. The urologist may suggest injections. Patients will learn in the office how to administer a very low-pain injection at the base of the penis. There are very few cases where neither the oral or injected medication solves the issue.

Outcomes are best when the patient feels comfortable talking to his urologist about sensitive issues. The Advanced Urology Institute has urologists who can treat erectile dysfunction in a way that puts a patient at ease. For more information, visit the Advanced Urology Institute website.

What is the Prevalence of Erectile Dysfunction, According to Dr. Harris?

KEY TAKEAWAYS:

  • Erectile dysfunction (ED) is a common issue that can result from both mental and physical factors, such as depression, anxiety, stress, heart disease, diabetes, high blood pressure, and substance abuse.
  • Certain risk factors, including heart disease, diabetes, tobacco use, drug and alcohol use, and being overweight or obese, increase the likelihood of developing ED.
  • Urologists can diagnose ED through a physical exam and questioning, and treatment options typically start with oral medications, followed by injections if medications prove ineffective.

Erectile dysfunction, also known as ED, is the inability of a man to get or maintain an erection firm enough for intercourse. ED is a very common issue that can negatively affect a man’s self-confidence and his relationship with his partner. Many men see urologists for help with ED when this happens.

Dr. David Harris of Fort Myers, FLThe primary symptom of ED is trouble getting and maintaining an erection, and reduced sexual desire is often associated with it. There are many factors that can cause ED, and they can be divided into two categories: mental and physical. Depression, anxiety and stress are mental factors that can cause ED. There are also physical factors, including heart disease, diabetes, high blood pressure and substance abuse. There are plenty of cases when it is a combination of mental and physical factors that cause ED.

All men are at risk for erectile dysfunction; however, there are some factors that increase the likelihood of developing it. Heart disease and diabetes are key risk factors that increase the likelihood of ED. Tobacco use causes damage to arteries, restricting blood flow and raising the chances of ED. Drug and alcohol use are risk factors as well. Men who are overweight, and especially those who are obese, are also at greater risk of developing erectile dysfunction.

A urologist can diagnose ED by performing a physical exam and asking a few questions. Once diagnosed, urologists can consider a variety of options for treatment, depending on the patient. The first option is usually oral medication. Urologists will try different medications to help patients maintain erections. If none are effective, then the urologist may prescribe injections. Small injections can be made to the shaft of the penis that dilate the blood vessels in the penis, allowing better blood flow and erections. The patient can administer these injections himself as needed.

Erectile dysfunction is not uncommon and as Dr. David Harris says about treating it, “As urologists, we are the leading authority.” Urologists see cases of ED on a daily basis and are accustomed to having conversations about it and finding the best way to solve the issue with their patients. In most cases a patient who is motivated to work with his urologist on finding the best treatment will eventually find a solution that works. The Advanced Urology Institute helps many patients explore their options and treat their ED so they can continue their normal lives and activities. For more information, visit the Advanced Urology Institute website.

TRANSCRIPTION:

My name is David Harris and I’m a urologist with Advanced Urology Institute in Fort Myers. That’s very common. And I think one reason men come into us is I think they understand that as urologists we’re the authority. And we have the literature, we have the established urological associations, understanding and framework from which to address this. And you’ll find ads in the paper, ads on the radio, a lot of quick easy ways to treat this. And patients come to us because they want to know that it’s safe and that they’re going to get an expert to tell them what to do. So yes, we see a lot of patients, it’s a daily thing, and I see in this day and age men much more comfortable coming in the office and saying, you know, Doc, I need a little help. You know, I’m not terrible, but I’m not where I was. Please help me with erections. And I think if you look back 15 years ago, there was less of that. So I think men are much more comfortable coming in and talking about it. And we have a variety of options. Okay. And that’s the same kind of thing. You have to talk to that patient about what their comfort level is, and their health issues, and help define for them the way you want to approach that. I think a fair statement, it doesn’t mean everybody’s got a fix for everything. But I think a guy that is very motivated can find an option to treat ED that will be successful.

REFERENCES:

Erectile Dysfunction Treatment Options

Although it is very common, erectile dysfunction can be an embarrassing subject to discuss even with medical professionals. ED can affect men of all ages and can be caused by a variety of factors, so a wide range of treatment options are available.

How Is Erectile Dysfunction Diagnosed?

According to the Mayo Clinic, ED is the chronic inability to get and maintain an erection. It can be diagnosed by talking with a doctor, ideally a urologist, about the patient’s medical history. The doctor may perform a series of tests, including a physical exam, blood or urine tests, an ultrasound, or even a psychological examination to determine if mental health is a factor in the patient’s erectile dysfunction. Sometimes ED is connected to another underlying issue. All of these factors come into play when determining treatment.

What Are The Treatment Options For Erectile Dysfunction?

Mikhail Lezhak, PA of Daytona Beach, FLThere are many potential steps to be taken in the ED treatment process. The first step, especially when the patient is a younger man, is usually medical management. Doctors may prescribe common medications like Viagra or Cialis. Both medications are taken only when needed. They do not help cause an erection until the patient has already become sexually stimulated. They are safe, commonly prescribed medications; however, they can cause serious side effects in combination with other medicines, especially nitrates.

For many patients, Viagra or Cialis is enough to help solve the problem of erectile dysfunction. If, however, they are not, another option is a penile injection. The initial penile injection may be given at the doctor’s office as a way to introduce the patient to the process. After this introduction, the patient can self-administer the injections at home as needed.

When these medications are not enough to solve a patient’s erectile dysfunction, another option is penile implant surgery. This is only recommended in cases where no other treatment option has been successful and when the patient’s ED has no chance of being reversed. There are a variety of penile implants on the market to accommodate a patient’s lifestyle and needs.

Erectile dysfunction can lead to feelings of embarrassment and shame, relationship difficulties and lowered self-confidence. However, there is no need to worry that these issues will last a lifetime. With the wide range of treatment options available, ED can be managed, allowing patients to resume normal sexual activity after consulting with their doctor. Our team of urologists at Advanced Urology Institute have extensive experience in working with patients experiencing erectile dysfunction. For more information, visit the Advanced Urology Institute website.

What is Erectile Dysfunction and How to Treat it?

Erectile dysfunction is the inability to have or maintain an erection firm enough for sexual intercourse. Any man may find himself occasionally unable to achieve an erection. That is normal. It is only when this inability becomes a sustained everyday occurrence that he may consider the possibility of erectile dysfunction.

The main factor for erectile dysfunction is aging, starting about the age of 50. Over 50 percent of men over 50 suffer from erectile dysfunction. Other risk factors include cardiovascular disease, high blood sugar, high blood pressure and high cholesterol levels. Emotional and mental conditions such as depression and anxiety also can cause erectile dysfunction.

Treating Erectile Dysfunction

Men who suffer from erectile dysfunction have a number of treatment options. If it is a symptom of an underlying illness, treatment should be focused on the underlying illness. When erectile dysfunction appears with no underlying cause, the following treatment options are available and are highly successful.

1. Oral Medication. These are pills given to increase blood flow to the penis, thus causing an erection. The most common ones are vardenafil or Levitra, Cialis or tadalafil, viagra and avanafil. Oral medication is most successful in patients with mild cases of erectile dysfunction.

2. Penile injections. The most common injectible drug is alprostadil. Using a very fine needle, a patient injects the drug into the base of the penis. The drug increases the size of the arteries that supply blood to the penis. Alprostadil also can be administered by placing a small alprostadil suppository at the opening of the penis, rather than by injection.

3. Vacuum erection device. This is a tube with a hand or battery powered pump. The tube is placed over the penis and the pump is used to draw air out, creating a vacuum. The vacuum thus draws blood into the penis, causing an erection.

4. Penile implants. A minor surgical procedure is used to introduce bendable rods at the sides of the penis. These rods give the penis a firmness that allows for intercourse. An alternative of the rods is the insertion of fluid filled cylinders connected to a pump placed in the scrotum. Engaging the pump inflates the cylinders which causes the penis to firm up.

It is advisable for men, especially those approaching age 50, to maintain a healthy relationship with a urologist. An experienced urologist can diagnose and offer advice on the best treatment options. It is also important to stay informed on the causes, signs and symptoms of erectile dysfunction. Many professional sites, such as the one maintained by the Advanced Urology Institute, are very helpful. Advanced Urology Institute also has an experienced team of specialists who can help with consultation, diagnosis and treatment. 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.

Treating Erectile Dysfunction


Like every other medical condition, the treatment of erectile dysfunction is safer and more effective when done by a doctor with expertise in treating it — the urologist. Seeing a urologist as soon as you have ED symptoms not only ensures quick relief, but also saves a lot of money. But with so many phony cures being promoted and ED products being advertised, men with ED are often tempted to pursue such options rather than seeing a urologist.

The rush for seemingly convenient cures

Actually a lot of men often rush to vascular clinics to get tests done and undergo procedures, some they do not even need. For many, it is a question of seeking the most convenient or popular remedy rather than the safest and most effective treatment. Likewise, with Viagra now generic and cheaper — available for as low as 30 cents per pill in several outlets — it has become quite easy for ED patients to just buy the drug and try it without seeing a urologist.

Dangers of non-prescribed treatments for ED

While it is safe to say that millions of men find these non-prescribed treatments a convenient way of improving their sex lives, it is never prudent to use a prescription drug such as Viagra when it has not been prescribed by a doctor. These medications come with side effects and risks, and if you have certain medical conditions taking such a drug can lead to severe consequences. For example, if you have heart disease and are taking nitrates, a dangerously low blood pressure may develop if you take Viagra. But when the drug is prescribed by a urologist, the doctor will ensure that you are healthy enough to start using the medication.

So why should you still see a urologist?

Most of the treatments advertised are not only bogus and a waste of money, but also may be harmful. Actually you may try several solutions without relief and eventually find yourself in a worse situation than before you started. So it is wise to just forget about every ED treatment that does not require a prescription. It won’t cure your condition! And when you find products advertised as a “breakthrough” or endorsed by medical organizations, you still need to check them out with your urologists. It is the doctor who should confirm whether or not the product is legitimate, a medical breakthrough or has been endorsed by a reputable medical organization.

Not everyone may take ED medications

ED medications are not for everyone with the condition. The drugs will work for some men, but they may be unsafe or inappropriate for others. You should see a urologist to learn whether your condition requires treatment with ED drugs. A urologist will take your medical history, do a physical exam and order various tests to determine whether you need treatment and which drugs are best for you.

You may have ED due to untreated diabetes, hypertension (high blood pressure), your current medications or another issue. Your ED also may have gotten worse because of stress, depression or anxiety. So it is crucial that you are evaluated by a urologist to determine the underlying cause and provide the right treatment. Remember also that erectile dysfunction may be a sign of another more serious health problem and will not be resolved if the underlying issue is not addressed. So you need to see a urologist to get a comprehensive, effective and safe treatment for your condition.

As urologists, we talk with our patients openly, get to know their medical history, conduct physical exams, and recommend treatment tailored to the individual. In many cases, we recommend erectile medications. But when the drugs fail, we have several alternatives to offer, ranging from penile injections and vacuum devices to penile implants. When you work with a urologist, your condition will be evaluated and the solution offered will not only improve your sexual health, but also boost your long-term health. For more information on the treatment of 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.