Erectile Dysfunction

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Erectile Dysfunction Introduction

The most important step to find effective erectile dysfunction (ED) treatments is to meet with doctor who will perform a complete history and physical examination.  In many cases, this is done by a Primary Care doctor and in other cases, it is done by a Urologist.  In some cases, but not always, certain tests may be ordered.  The most common first step in treatment in most cases is the the Rx of an oral medication like Viagra, Cialis, or Levitra.  When, pills fail to lead to an adequate response, this is when men generally seek our help.   Dr. Joel Gelman at UC, Irvine in Orange, California is an expert in erectile dysfunction treatments, and the Center for Reconstructive Urology can help determine the best options for erectile dysfunction for each individual case.

What is Erectile Dysfunction?

ED is when an individual is unable to achieve or maintain an erection, making it difficult or impossible to achieve adequate rigidity for sexual intercourse. There are a variety of different causes and symptoms of ED.

Erectile Dysfunction Treatments

In general, prior to the treatment of a medical condition, blood tests or other tests are often performed, and this is a called a diagnostic evaluation. When the problem is Erectile Dysfunction, some Urologists will perform a series of tests, including very invasive procedures, before determining which erectile dysfunction treatments may work best.  At the Center for Reconstructive Urology, we have the expertise to perform complex testing such as a sophisticated ultrasound of the penis (called a penile duplex) before and after the injection of a medication that induces an erection.  Some patients have the expectation that they will have this testing.  Certainly, when a test is done, it benefits the doctor doing the test.  However, tests which are associated with expense and possibly some invasiveness and risks should only be performed then the result influences decision making.  If the test shows one thing, you do this.  If it shows something else, you do that.  If the erectile dysfunction treatment plan will not be influenced by a test result, we favor not doing that particular test. Below are some of the common options for erectile dysfunction.

Medical Therapy

For most patients, the first type of treatment will be medical therapy. Most doctors will prescribe oral medication as long as the patient does not have cardiovascular or other medical issues that prevent use. Popular oral medications include Viagra and Cialis and Levitra. There are also medications that are inserted into the opening of the urethra or injected into the side of the penis. If medication does not have the desired effect or are not appealing, other options for erectile dysfunction will be explored.

Penis Pump

Another non-surgical treatment option is a vacuum erection device, also known as a penis pump. The device creates a vacuum between the pump and the penis, promoting blood flow into the penis in order to help an individual achieve an erection. The term “penis pump” can also be used to describe a penile implant, also called a penile prosthesis, which is placed surgically inside the penis, but the vacuum erection device is a penis pump that is placed over the penis to induce an erection and then removed.

Penile Revascularization Surgery

Penile revascularization surgery is a way to try to improve blood flow to the penis to better achieve and maintain an erection. However, the surgery is not recommended for most men and is only really suggested for men who have sustained a pelvic fracture trauma that led to their ED.

Penile Implant Surgery

If the above treatment methods prove to be ineffective, then penile implant surgery may be the best treatment option. The surgery places an inflatable penile prosthesis below the skin of the penis, allowing the patient to achieve an erection. There are various penile implant types that can effectively address ED from practically all causes, and we explain these options to our patient so they can make the best treatment decision.

An Individualized Approach to Erectile Dysfunction Treatments

When it comes to erectile dysfunction treatments, the key to getting results is an approach that emphasizes the patients and the process. At the Center for Reconstructive Urology, Dr. Gelman does not schedule patients for surgery without an initial consultation (that includes a physical exam) to first determine that a penile implant is truly the best treatment option for his erectile dysfunction. Our individualized approach is to extensively counsel patients regarding all options, explain the risks and benefits of each option, and favor the least invasive option that provides the desired result. This is actually a requirement for a patient to give informed consent for any treatment.

The sub-sections on the left side of this page provides information about the anatomy of the penis, an explanation of how erections occur, what causes erectile dysfunction, ED treatment options, and our approach to ED treatment at the Center for Reconstructive Urology.