Erectile dysfunction (ED), also known as impotence, is the inability to get and keep an erection firm enough for intercourse.
Most men will have ED occasionally, and this is not cause for any worry. However, if ED becomes a consistent problem, it can cause emotional distress, impact your quality of life and may be an indicator of an underlying health issue.
If you are suffering from ED, talk to us. Our experts at City of Hope have many effective treatment options available for you.
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As a founding member of the National Comprehensive Cancer Network, our doctors also help develop and improve evidence-based prostate cancer treatment guidelines for patients throughout the country.
The physicians in our Division of Urology and Urologic Oncology are leading experts in treating patients with all types of urologic disorders and cancers. Just as no two patients are alike, erectile dysfunction requires a unique treatment plan tailored to each individual to attain the best possible outcomes.
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The penis is comprised of three main chambers: the urethra, where urine and semen pass, and the paired corpora cavernosa. The corpora are composed of a firm elastic layer called the tunica albuginea, and the inner erectile tissue called the corpora cavernosa, that fills with blood during an erection.
For an erection to occur, there are three important factors: stimulation, the nerve function in the penis and the blood flow to fill the corpora to induce an erection. When any of these factors are impacted, erectile dysfunction (ED) can occur.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, a variety of physical and psychological or emotional issues can cause ED. Physical causes include damage to the nerves, arteries, smooth muscles, and fibrous tissues in the penis.
Diseases and disorders that cause damage and can lead to ED include:
Psychological or emotional issues, such as the following, can also contribute to ED:
Contributing factors to ED include:
Men with an underlying disease that can cause ED are more likely to develop ED. ED affects men of all races and in all regions. Researchers estimate that ED affects as many as 30 million men in the United States.1 While the likelihood of ED increases with age, the aging process does not cause ED. ED occurs in:
At City of Hope, we diagnose ED by identifying reversible causes, discussing what treatments have been attempted previously and completing a thorough medical history and physical exam.
In some cases, blood work may also be necessary to identify hormonal problems and any treatable conditions like hyperlipidemia, hypertension and diabetes. We will also review each patient’s medication list to make sure no prescriptions are impacting erectile function.
In rare cases, doctors may perform ultrasound testing of the penis to ensure that there is appropriate blood flow, occlusion of blood flow and retention of blood to maintain an erection.
We may also perform injection testing to see if there is normal response to medications that induce erections. This not only helps in diagnosis, but it also introduces treatment options for ED.
At City of Hope, we employ several methods for treating ED, such as:
Oral medications used to treat ED include, sildenofil (Viagra), tadalafil (Cialis), vardenafil (Levitra or Staxyn), and avanafil (Stendra). These medications should never be taken with nitrate drugs for chest pain, and they should be taken under close supervision by a medical professional in any patient taking alpha blockers for hypertension or enlarged prostate.
City of Hope brings expert urologic care to treating any urologic condition.
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