Erectile Dysfunction

• ​Overview
• ​Causes
• ​Treatment Options

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Erectile dysfunction (also known as ED or impotence) is the inability to achieve or maintain an erection firm enough to have or complete sexual intercourse. Experiencing ED from time to time is normal. As many as 40% of men in their 40s, 50% in their 50s and 60% in their 60s experience ED occasionally. However, ongoing erectile dysfunction may indicate an underlying chronic or more serious health complication, including poor circulation to the heart. If you are concerned about erectile dysfunction, we can help you to achieve a healthier and happier sex life, as well as to assess your overall health risk.

The evaluation of erectile dysfunction can be complex, with any of a number of various underlying causes being responsible, and often a combination of these.
 
Erectile dysfunction can occur as a result of a number of physical and psychological factors, such as:

• Smoking cigarettes/ marijuana
• Excessive alcohol consumption
• Low testosterone
• Stress and anxiety
• Relationship problems

 
In many cases, erectile dysfunction has a physical cause:

• Vascular disease (arteriosclerosis)
• Diabetes Mellitus
• Peyronie’s disease (curved penis)
• Kidney failure
• Drugs (prescription and over-the-counter)
• Neurological conditions
• Pelvic trauma (injury, surgery, or radiation)
• Venous leak

 
In most cases, ED is a combination of psychological and physical factors. These can include depression, performance anxiety, and stress. Mental health factors are usually secondary to physical causes of ED, so it is important to speak with a doctor if your symptoms persist or become more frequent.

We follow a step-wise approach to the treatment of ED, starting with oral medication. This is by far the most non-invasive, safest and cheapest option, and is universally considered the first-line therapy. We only advocate progression to second line therapies if there is an unsatisfactory result from the initial ones.
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• Oral Medication: Prescription medications with selective enzyme inhibitors can be very successful in the majority of cases. They are more commonly known by their brand names – Viagra®, Levitra® and Cialis®. Although they are considered very safe to use, there is a small subset of patients who are at risk for adverse effects following taking these medications. We screen patients thoroughly to ensure their safety; if you have pre-existing severe heart disease such as heart failure or unstable angina, or had a recent heart attack, we will arrange a cardiology evaluation for clearance to take these drugs. Your safety and satisfaction are our primary concern.
• Other Therapies: Patients who cannot take oral medications or undergo surgery may be candidates for a vacuum erection device, medicated urethral pellet (MUSE®), intraurethral gels, or penile injection therapy.
• Surgical Procedures: Surgery can also help men who have failed other therapies overcome ED. Surgical treatment has a 95 percent satisfaction rate and can also effectively treat simultaneous conditions such as Peyronie’s Disease (penile curvature). A penile prosthesis can be surgically inserted, allowing you to achieve a satisfactory erection whenever you choose, for as long as you choose.

 
During your initial consultation and evaluation, we can determine the best treatment option for you. We will thoroughly explain your options so that you can make an informed decision.