Andrology and Genito-Urethral Surgery Endourology Female, Neurological and Urodynamic Urology Oncology
If you have symptoms like needing to pee more often, you may also need to have an examination of your prostate. Treatment for erection problems depends on the cause .
Pelvic Floor RehabilitationMale Fertility TreatmentsMale Sexual TreatmentsPenile RejuvenationPenis EnlargementsCouple TherapyNightfall TreatmentPsychotherapy / Sex TherapyVaricocelectomyP Shot for Penile Enhancement3 Tesla Electromagnetic Stimulation TherapyPE treatment with HA Fillers
The duration of ED depends on what causes it and how you respond to your treatment. Many men notice an immediate improvement when they start on medication or another form of treatment.
90% of men with impotence (erectile dysfunction) have at least one underlying physical cause for their problem
The third Princeton Consensus (Expert Panel) Conference recommends assessing cardiovascular risk in all patients with ED and CVD. This refers to estimating the risk of mortality and morbidity associated with sexual activity. The current recommendations classify patients into low-, intermediate- and high-risk, based on their New York Heart Association class.57 The consensus also recommended that all patients with ED and CVD should undergo lifestyle changes, such as exercise, smoking cessation, healthy diet and weight reduction. These measures are likely to reduce cardiovascular risk and improve erectile function.58
When talking to your doctor, be as open and honest about your symptoms as possible. Tell your healthcare provider how often you have symptoms and how long you’ve had them.
If nothing else works (or if these other options don't fit into the patient's lifestyle), there is always a penile implant. A penile implant (or Inflatable Penile Prosthesis – IPP, as most urologists call it) is a hydraulic device that gets implanted into the penis and replaces the erectile tissue with two cylinders. There is a little pump that gets placed into the scrotum, next to the testicles (not into the testicles) to inflate and deflate the device.
Risks associated with injection therapy including bleeding, pain with injection, penile pain, priapism, and corporal fibrosis (scarring inside of the corpora cavernosa). There is also concern that repetitive injections in the same area could cause scar tissue to build up in the tunica albuginea that could create penile curvature. Thus, doctors recommended that one alternate sides with injection and perform injections no more frequent than every other day.
You get an erection when blood fills two chambers known as the corpora cavernosa. This causes your penis to expand and stiffen, much like a balloon as it is filled with water. Impulses from the brain and genital nerves start the process. Anything that blocks these impulses or restricts blood flow to the penis can cause ED.
As experts in the field of erectile dysfunction, we offer a full range of treatment options. We can even help men who have not succeeded with prescription medications, such as Cialis® and Viagra®.
Aetna considers the following therapies for the treatment of erectile dysfunction medically necessary:
Low self-esteemStressAnxietyRelationship issuesA lack of intimacyAn unfulfilling sex lifeInability to get your partner pregnant
If your doctor rules out other causes, he or she may prescribe Sildenafil (brand name: Viagra), tadalfil (brand name Cialis), and vardenafil (brand name Levitra). These medicines are taken by mouth to help you maintain an erection.
Besides PDE5 inhibitors and among second-line therapies are VCDs which are clear plastic chambers placed over the penis, tightened against the lower abdomen with a mechanism to create a vacuum inside the chamber. This directs blood into the penis. If an adequate erection occurs inside the chamber, the patient slips a small constriction band off the end of the VCD and onto the base of the penis. An erection beyond 30 min is not recommended. These devices can be a bit cumbersome, but are very safe.40
Link between oxidative stress, endothelial dysfunction and ED. CVD, cardiovascular disease; ED, erectile dysfunction.
In patients who either fail to respond to first or second-line therapy, or are not interested in the conservative therapies, penile prosthesis implantation is available. Malleable and rigid implants were available for many years, but in 1973 the world of penile prosthetics took a giant leap forward with the advent of the inflatable penile implant. Most implants done nowadays are of the inflatable variety. Adverse events including malfunction and infection are rare, and patient satisfaction is very high.45