Men's Health

Erectile Dysfunction

Has your sex drive taken a nose dive? Are you having trouble rising to the occasion or making the moment last? At Urology Partners, our world-class physicians help men get their mojo back. You don’t have to say goodbye to a satisfying love life.

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What is erectile dysfunction?

Sometimes known as impotence, erectile dysfunction (ED) is the inability to achieve or maintain an erection strong enough for sexual intercourse. About 20 percent of men age 20 and older suffer from a loss of libido and ED. By age 70, nearly 50 percent of men have difficulty getting or keeping an erection. For many men, it can be frustrating, embarrassing and a source of anxiety and depression.



What causes ED?

The natural aging process plays a role. Testosterone levels tend to drop when men turn 40, which can affect a man’s libido. Other than aging, ED is usually attributed to one of three causes—a lack of blood flow to the penis; the inability to keep blood trapped in the penis long enough to maintain an erection (called venous leak or cavernosal dysfunction); and nerve damage that short-circuits signals from the brain or spinal cord to the penis.


What are some of the risk factors?

Erectile dysfunction can also signal more serious health issues that need medical attention or lifestyle changes. Smoking, heart disease and high blood sugar can reduce blood flow to the penis. Certain illnesses, injuries to the penis or surgeries in the pelvic area may damage nerves in the penis. Certain medications used to treat high blood pressure, allergies, depression and ulcers can also contribute to ED.

 

We're Here To Help

With an experienced team of specialists in men's health issues, UP offers a variety of effective
treatment options for Low T, erectile dysfunction and permanent birth control.

Oral Phosphodiesterase-5 Inhibators Vacuum Erection Device MUSE Injections Penile Injection Therapy Penile Implant Male Infertility



Oral Phosphodiesterase-5 Inhibitors


Phosphodiesterase-5 (PDE-5) is an enzyme that is naturally produced by the body. When the body produces too much PDE-5, it interferes with signals that tell smooth muscle cells lining blood vessels in the penis to relax during sexual arousal. When the muscle cells can’t relax, blood flow to the penis is restricted—preventing erections. Oral PDE-5 inhibitor medications such as Viagra, Cialis and Levitra reduce the amount of PDE-5 so blood can flow into the penis. Oral PDE-5 may be prescribed for use every day or several times per week. It is not recommended for men who take nitrates, alpha blocker medications or those who have serious liver, kidney or heart conditions.

Vacuum Erection Device


Most men aren’t thrilled by the thought of using a vacuum erection device (VED), but it provides important physical therapy for the penis after prostate cancer treatment. Patients are provided with a prescription for a VED—a plastic cylinder that is closed on one end and fitted with a seal around the open end. The penis is inserted into the cylinder through a hole in the seal.  When pressed against the body, the cylinder creates a vacuum using either a hand pump or small battery-operated pump. The vacuum draws blood into the penis causing an erection. This stretches the penis to help prevent the loss of penile length and the development of scar tissue. It also improves blood flow and oxygenation which are vital to sexual function. A retaining band can be transferred from the VED to the penis to maintain the erection after the VED is removed.  Nightly use of a VED can make a significant impact on the ability to develop erections sufficient for intimacy.

MUSE Injections


Unlike PDE-5 inhibitors which require functioning nerves to increase blood flow and oxygenation to the penis, the medicated urethral system for erections (MUSE) does not. It uses a small pellet containing alprostadil, a potent vasodilator that widens arteries so they can carry more blood. MUSE is very effective at producing erections, but because it is so potent, it must be administered directly into the penis. Patients use a tube-like applicator to deposit a small pellet directly into the urethra. The alprostadil is absorbed through the membrane that lines the urethra, promoting increased blood flow and oxygenation in the penis. An erection develops in about 10 minutes and lasts for about 30 minutes. Although some men report mild pain while the alprostadil is being absorbed, it decreases with each application. The number of MUSE treatments per week will vary depending on the individual and their prescribed rehab regimen. In some instances, MUSE may be used along with a PDE-5 inhibitor.

Penile Injection Therapy


For patients who do not respond to oral PDE-5 inhibitors or other treatments, penile injection therapy can be a good option. As daunting as it may seem, this therapy has a very high efficacy rate because it doesn’t involve nerve stimulation. Studies show that 80 percent of men who have penile injections develop a natural feeling erection firm enough for intimacy. The injections are also fast-acting. Immediately prior to intimacy, the patient or their partner injects the medication into the side base of the penis. The proper dosage is determined by your UP physician. The injection causes blood vessels to dilate and the penis to become erect within five to 10 minutes. Erections typically last for approximately 30 minutes. Some men may experience mild pain, not from the needle insertion, but rather from the medication. For men who feel pain from the needle prick, a topical anesthetic can be applied before the injection. Because the injections are self-administered, you or your partner must physically be able to see the injection site and have the dexterity to safely administer the injection. Penile injections are not an option for men with a hypersensitivity to vasoactive medications or who suffer from sickle cell anemia, multiple myeloma or leukemia.

Penile Implant


Once cumbersome and awkward, penile implants have come a long way from the crude models introduced in the 1970s. Today, a state-of-the-art, three-piece inflatable implant can be totally concealed within the body. Most importantly, the implant can be discreetly inflated and deflated on demand via a squeezable pump that is placed in the scrotum. The pump channels fluid from a small reservoir implanted next to the bladder to a pair of inflatable cylinders in the penis, inflating the implant.

When the implant is inflated, the penis expands in length and girth, and has the rigidity and appearance of a natural erection. When it is deflated, the implant becomes soft and flaccid. Unlike oral medications, an implant lets the wearer decide when he wants to have an erection and how long he wants it to last. Implants allow wearers to be spontaneous with their partners and have sex when the mood strikes.

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