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The penis is composed of three cylinders, two on the top and one on the underside of the penis. The top two cylinders are involved in the erectile process. The urethra, the tube that urine and semen pass through, is on the underside of the penis. The top two penile cylinders, the corpora cavernosa, are composed of tissue that is analogous to a sponge, containing spaces that can fill with blood and expand. These two cylinders are surrounding by a strong layer of tissue, like Saran wrap, the tunica albuginea. For an erection to occur, there must be properly functioning nerves, arteries, veins, and normal penile tissues. Share Your Story

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1. Identify the pelvic floor muscles: To find the pelvic floor muscles, you can either stop urination midstream or squeeze the muscles that stop you from passing gas.
Johns Hopkins Bloomberg School of Public Health: “18 Million Men in the United States Affected by Erectile Dysfunction.” .

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Hormonal therapy is not used as a primary therapy for the treatment of ED. Testosterone therapy is used if there is ED and symptoms of low testosterone, as well a low blood level of testosterone.
“We Recommended that men with ED be screened for depression and men with depression be screened for ED.”

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Watching porn may extinguish erections in the bedroom. But the brain, not the penis, is the problem.
Some men should not take PDE5 inhibitors. They can cause hypotension (abnormally low blood pressure that can lead to fainting and even shock) when given to patients who are taking nitrates (medications taken for heart disease). Therefore, patients taking nitrates daily should not take any of the PDE5 inhibitors. Nitrates relieve angina (chest pain due to insufficient blood supply to the heart muscle because of narrowing of the coronary arteries); these include nitroglycerine tablets, patches, ointments, sprays, and pastes, as well as isosorbide dinitrate and isosorbide mononitrate. Other nitrates such as amyl nitrate and butyl nitrate also are in some recreational drugs called "poppers."

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Aetna considers the diagnosis and treatment of erectile dysfunction (ED; impotence) medically necessary according to the criteria outlined below.

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The doctor will examine the liver, kidney, fat, blood. For those who have low sexual desire, you may need to take hormone to increase testosterone. Also observe the erection of the penis during sleep if it cannot erect at night or at dawn, the cause is probably caused psychological.

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    "Medications that create blood flow to the penis can't help when an erection is blocked by the fear or anxiety of the fight-or-flight response,” says Feloney. “This type of erectile dysfunction probably has a lot to do with evolution — men didn't need an erection when a dinosaur was chasing them." The best way to treat erectile dysfunction caused by performance anxiety, depression, a poor relationship, or stress may be with a combination of ED drug treatment and sex therapy, individual therapy, or couples therapy from sexual health professionals.

    The penis contains three cylinders, the two corpora cavernosa, which are on the top of the penis (see figure 1 below). These two cylinders are involved in erections. The third cylinder contains the urethra, the tube that the urine and ejaculate passes through, runs along the underside of the penis. The corpus spongiosum surrounds the urethra. Spongy tissue that has muscles, fibrous tissues, veins, and arteries within it makes up the corpora cavernosa. The inside of the corpora cavernosa is like a sponge, with potential spaces that can fill with blood and distend (known as sinusoids). A layer of tissue that is like Saran Wrap, called the tunica albuginea, surrounds the corpora. Veins located just under the tunica albuginea drain blood out of the penis. SLIDESHOW Erectile Dysfunction (ED) Causes and Treatment See Slideshow Readers Comments 5 Share Your Story
    The risk of having ED after prostate cancer treatment depends on the surgical technique or type of radiation used by your doctor, but also on your:

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    Pelvic floor exercises tighten the muscles around the base of the penis. These muscles exert pressure on the blood vessels that drain the penis. Tightening these muscles can help keep blood in the penis longer and therefore help maintain an erection. Pelvic floor exercises (also called Kegel exercises) can tighten the muscles that sag and weaken as we age (Meldrum et al., 2014).

    Once you feel comfortable with this feeling, you can incorporate this into a daily routine of performing pelvic floor exercises. It won't take long, and will soon feel like second nature.
    Many men have micro-plaque in their penises without realizing it. Contact sports, other athletic activity, and vigorous sex can cause the formation of micro-plaque. As a man accumulates micro-plaque over time, he can develop conditions like Peyronie’s disease, which can cause erectile dysfunction. Peyronie’s disease leads to painful curvature of the penis that can make sex impossible or unenjoyable. GAINSWave® therapy breaks down micro-plaque to treat or prevent Peyronie’s disease.

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    Smoking, excessive use of alcohol and illicit drugs are also associated with ED.13 A study in 2005 suggests that ED is not only more likely among men who smoked compared with those who never did, but that in younger men with ED, cigarette smoking is very likely the cause of their impotence.14 15

    Some men experience symptoms only occasionally. For others, the symptoms are constant and interfere with their sexual relationships.
    You’ve probably heard of sildenafil (Viagra), but it isn’t the only pill for ED. This class of drugs also includes avanafil (Stendra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn). All work by improving blood flow to the penis during arousal. They're generally taken 30-60 minutes before sexual activity and should not be used more than once a day. You can take tadalafil up to 36 hours before sexual activity. It also comes in a lower, daily dose. All require an OK from your doctor first for safety.

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    In many cases, erectile dysfunction is caused by something physical. Common causes include:

    As many as 30 million men in the U.S. experience erectile dysfunction (ED). Often, ED stems from an underlying physical disorder, such as vascular disease, high blood pressure (hypertension), or diabetes, or from side effects of medication or urological procedures.
    Urology Care Foundation is an organization that supports and improves urological care by funding research, developing patient education, and pursuing financial support. They offer downloadable fact sheets and patient guides to help you understand ED.

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Complete List Top Do Urologists Treat Erectile Dysfunction Related Articles Erectile Dysfunction (ED, Impotence)

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One must be very careful using both PDE5 inhibitors and medications commonly used to treat an enlarged prostate, alpha-blockers (for example, tamsulosin [Flomax], terazosin [Hytrin]). It is recommended that one be on a stable dose of the alpha-blocker prior to starting a PDE5 inhibitor and that one start on a low dose of the PDE5 inhibitor and increase as tolerated and needed to treat the erectile dysfunction. Similarly, if you are on a PDE5 inhibitor and your doctor recommends that you start an alpha-blocker for your prostate, you should start at a low dose and increase as tolerated and needed to treat your prostate symptoms.

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Treating other health problems, such as diabetes or high blood pressure, can sometimes cure ED. If our urologists suspect that your ED is caused by an underlying medical condition, they may refer you to a specialist for treatment.

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Penile self-injection therapy is a shot that is inserted into the penis and produces an erection for up to an hour or more. This injection is mostly used to treat erectile dysfunction, but can help with other penile conditions as well.

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