The team at Affiliated Urologists is experienced in offering a variety of treatments for erectile dysfunction. Each patient will be evaluated based on his individual needs and an appropriate treatment plan will be disussed.
Oral medications are often the first line of treatment for patients suffering from erectile dysfunction (ED). Some of the most common medications for this condition include Sildenafil (Viagra), Tadalafil (Cialis), Vardenafil (Levitra, Staxyn), and Avanafil (Stendra). These medications are usually well received and cause very few side effects in patients. Oral medications for ED increase blood flow to the penis by enhancing the effects of nitric oxide, a chemical in the body that relaxes muscles. Each medication for ED works in a similar fashion, but they have different chemical make-ups, which can affect the way each medication works.
For example, Sildenafil (Viagra) is most effective when taken on an empty stomach one hour before sex. This medication can also last up to six hours when taken appropriately. Other medications, like Tadalafil (Cialis), can be taken without or without food approximately one to two hours before sex. This medication is effective for 36 hours and can be taken as a daily medication or on an as-needed basis. It’s important patients talk to their urologist about their health history before using oral medications for ED. These medications can be dangerous for patients who take nitrate drugs, have low or high blood pressure, severe liver disease, or kidney disease.
Alprostadil and Trimix Self-Injection or Intraurethral Suppository (MUSE)
Alprostadil and Trimix self-injections or intraurethral suppositories (MUSE) are treatment options for patients suffering from ED. As the name of the therapy suggests, patients can either have the medication injected directly into the penis by a physician or the patient; or, patients can use Alprostadil as a suppository, placing it into the opening of their penis. Both medications are available by prescription only. Each medication works by expanding blood vessels and boosting blood flow throughout the body. While both medications can be highly effective, the injectable form generally produces better results.
Generally, these medications begin working five to 20 minutes after they’ve been injected or placed into the penis. Patients who used Alprostadil or Trimix should wait 10 to 30 minutes before engaging in sexual intercourse. Furthermore, patients should wait at least 24 hours between each use and avoid using these medications more than three times a week. As with any ED medication, these drugs are not for everyone and can produce serious side effects if not used appropriately. Patients with bleeding problems, penile infections, or blood disorders may not be considered candidates for either treatment.
Vacuum Erection Device (Pump)
Vacuum erection pumps are noninvasive cylindrical devices that mechanically create penile blood engorgement. These devices contain a vacuum chamber and pump to produce negative pressure and constriction, resulting in an erection. Vacuum erection devices (VEDs) are usually recommended for patients suffering from organic or psychogenic ED. This generally includes a number of “organic etiologies” such as diabetes, arterial insufficiency, spinal cord injury, or postprostatectomy. To use this device, patients must first coat their penis and the pump’s constriction rings with a water-soluble lubricant. Next, patients will need to load the rings into the cylinder base before placing the device over their penis.
The base of the device should be held firmly against the pubis to maintain a seal. When the patient is ready, he will use the pump to create negative pressure inside the cylinder. This will draw blood into the corpora cavernosa, which will help produce an erection. After the penis has been engorged, a constriction band should be placed around the base of the penis to maintain the erection. While VEDs are the least invasive treatment option for ED, they are also usually the least effective treatment option. If used improperly, patients may experience painful erections and other complications such as bruising, bleeding, numbness, and petechiae (bleeding under the surface of the skin).
Penile Implants (Inflatable Penile Prosthesis)
A penile implant, also known as a penile prosthesis, is a treatment option for men suffering from erectile dysfunction (ED). Penile implants are placed inside the penis to help men get and maintain an erection during sex. There are two types of penile implants available on the market today: semi-rigid and inflatable. Both of these penile prostheses work in different ways, so patients should consult their urologist about the function of each device before choosing one over the other. A semi-rigid, non-inflatable penile implant may be ideal for men who are looking for something inexpensive and easy to use. Inflatable penile implants, on the other hand, may be a good option for men who want the best flaccidity when the device isn’t in use. Again, patients should talk to their urologist about a penile prosthesis that is right for them.
As the name suggests, penile implants do need to be surgically implanted into the penis in order to work. Depending on the type of implant chosen, patients may experience some complications from their implant, such as frequent urinary tract infections or dermatitis of the penis or scrotum. It’s important to note penile implants help men get an erection; they do not increase a man’s sexual drive or sensation. Moreover, surgery for a penile prosthesis is usually only considered after all other conservative and interventional treatment options have been tried on the patient.
Stem Cell Therapy
Stem cell therapy is a relatively new treatment option for patients affected by erectile dysfunction (ED). Stem cells have regenerative properties that can help replace damaged cells and repair injured tissues. During this procedure, stem cells are taken and harvested from a patient’s bone marrow or autologous fat before being transferred into penile tissues. Because stem cells use the body’s own natural reparative factors, there is little risk of infection, rejection, and other complications. Scalpels and knives are not used during the procedure, so patients experience minimal swelling, bruising, and redness with no visible scarring.
Patients can typically resume their normal daily activities shortly after the procedure. Results from stem cell therapy can be seen and felt after two to 4 weeks with gradual improvement occurring over several months. Many patients report an overall improvement in their erection and performance that lasts years. Stem cell therapy is not usually covered by health insurance plans, so patients are encouraged to speak with their urologist about cost and financing options.