Erectile Dysfunction Treatments

At City of Hope, we employ several methods for treating ED, such as:

Lifestyle Modifications

  • Maintaining behaviors that positively impact heart health may help combat ED. Eating a heart healthy diet, exercising, reducing stress, stopping smoking and avoiding excess alcohol are all helpful in treating ED.
  • Hypertension, high cholesterol and diabetes are the three most common conditions that affect erectile function. Controlling these illnesses is vital to maintaining penile health.

Oral Medications

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.

Surgery

  • Penile prosthesis (penile implant): 40 million men suffer from ED. When Viagra, Cialis and other pills fail, penile implants are a popular and effective option.
    • Reports indicate that the penile implant has the highest degree of satisfaction because of its spontaneous and reliable results.
    • There are two types of implants, those that inflate and deflate, and those that are always firm (semirigid).
    • The implant is placed through a small three centimeter incision within the tunica albuginea, which allows the penis to become rigid for intercourse.
    • This 30-40 minute outpatient operation has a 98 percent patient and partner satisfaction rate, making penile implant the most successful operation for ED. The operation is covered by nearly all insurance, and is the only ED treatment covered by Medicare.
    • Penile implant devices are recommended after other therapies have failed. Once an implant is placed, no other form of treatment will work.
    • The risks of penile prosthesis include infection, bleeding and pain. In addition, the device is a mechanical device, and over time it can break down. But with new models, the rate of mechanical failure and infection is incredibly low.

Other Treatments

  • Vacuum erection device: This is a chamber placed over the penis to create a vacuum, which pulls blood into the penis. After the penis is erect, a restrictive band is placed at the base of the penis to trap the blood in the penis.
    • The device works very well, though some patients report dissatisfaction with the cumbersome nature of the vacuum. In addition, the penis may be hinged and rigid beyond the restrictive band, and flaccid closer to the body.
    • Additionally, the penis tends to be cool to the touch, as there is no active blood flow while the restrictive band is in place.
  • Penile injection therapy: There are medications that can safely be injected directly into the penis. These medications include alprostadil (Edex), papavarine and phentolamine. The first dose of the injection therapy is usually administered under the supervision of a health care provider.
    • While many men are apprehensive about giving themselves an injection, it can be an effective option when oral therapy does not work.
  • Muse: Muse is a form of the drug alprostadil. This small pellet is placed into the urethra to dissolve and be absorbed into the erectile tissue.
  • Elator: The elator is an external penile support device that places the penis on stretch to allow for penetration despite the lack of a firm erection.