OVERVIEW
Erectile dysfunction (ED) is the decreased ability to obtain or maintain an erection satisfactory for patient and/or partner.
Symptoms
You may experience the following symptoms:
- trouble obtaining or maintaining an erection
- decreased sexual desire
- less rigid erection
Causes
There are various physical and psychological issues that can result in poorer erectile function. These include, but are not limited to, increasing age, diabetes, heart disease, high blood pressure, low testosterone, peyronie’s disease (penile curvature) or stress/mental health issues.
Diagnosis/Evaluation
- What to know before your visit:
- During your visit, your doctor will ask you questions regarding your medical history and will perform an exam with focused attention to the abdomen and genitalia. Information regarding situations when you have difficulty obtaining erections, presence of morning/overnight erections, and any prior surgery or radiation is important for your visit.
- Tests that may be performed during or after your visit:
- Blood tests: Testosterone level may be obtained amongst other possible laboratory studies
- Penile ultrasound: This test involves using a small transducer held over the penis to assess the quality of blood flow to the penis. An injection of a medication into the penis to create an erection may be utilized to help determine your erectile function.
For patients with ED it is important to have a primary care physician as this condition may be associated with high blood pressure, diabetes, high cholesterol, or heart disease.
Treatment
NON-SURGICAL TREATMENT
- Prevention/Behavioral changes: Maintaining a healthy lifestyle is the best way to prevent the formation and progression of ED. This includes maintaining a healthy weight, controlling blood pressure and blood sugars, limiting alcohol, stopping smoking and exercising regularly.
- Medications: Viagra, Levitra, Stendra, Cialis are medications that improve blood flow to the penis in order to enhance your erection in response to sexual stimulation.
- When taking medications for ED there are a few important instructions:
- DO: Take 60-120 min (Viagra, Levitra, Cialis) or 30min (Stendra) prior to desired erection.
- Do NOT combine with nitrates (drugs taken for blood pressure or chest pain)
- Do NOT take if have low blood pressure
- Injection therapy: In those that fail or can’t take oral therapy, self-injection of a medication into the base of your penis often can lead to satisfactory erections. Erections should start within 10 min and should not last more than 1 hour. For erections lasting more than 4 hours, you must contact your physician immediately or go to the emergency room.
- Urethral suppository: This treatment involves placing a small suppository into the tip of your penis to improve blood flow to the penis. Erections start within 10 min and typically do not last more than 1 hour. The most common side effect is penile pain or minor bleeding.
- Penile pump: A vacuum erection device is a hand-powered pump that works by pulling blood into the penis. Once erect a ring is placed over the base of the penis (do NOT keep ring on penis for more than 30 minutes). These erections tend not to be as firm, can result in bruising, may be cold to the touch, and ejaculation will be obstructed from the restriction band.
SURGICAL TREATMENT
- Penile Implant: A surgical procedure involving the placement of cylinders/implant into your penis, a pump in your scrotum and a reservoir of fluid in your abdomen. This allows for a consistent erection and has a patient/partner satisfaction rate of more than 90%.
Schedule an appointment with a MidLantic Urology physician near you today!