Erectile Dysfunction

What is erectile dysfunction?

Erectile dysfunction, also known as “ED” or impotence, is the inability to achieve and maintain an erection suitable for intercourse.

Is erectile dysfunction common?

Yes. Erectile dysfunction is very common in men over the age of 50. Estimates suggest that as many as 30 million men in the United States may suffer from erectile dysfunction.

What causes erectile dysfunction?

The most common cause of erectile dysfunction is cholesterol-plaque buildup in the arteries of the penis (atherosclerosis), the same process that causes heart attacks and strokes. Plaque buildup is caused by smoking, obesity, and medical conditions such as diabetes, high blood pressure or high cholesterol.

Other causes of erectile dysfunction include side effects from medication, injury to the penis, psychological problems, and hormonal imbalance.

Can erectile dysfunction be successfully treated?

Yes. The vast majority of cases of impotence can be successfully treated. Even if one treatment such as medication is not effective, there are alternative therapies.

What treatment options are available?

Treatment options include medication, urethral suppositories, vacuum erection devices, penile injections and penile implants. We can help you select the treatment option that is best for you. We’re here to help.

Could it be psychological?

Most all erection problems are caused by physical problems, not psychological issues. It is very common and normal to have some degree of anxiousness, stress or even depression because of the stress of having erectile dysfunction.

What happens when I make an appointment for my erectile dysfunction?

We want to work with you to help you restore your sexual activity. Our first priority is to treat you with respect and privacy. Many men come to Minnesota Urology for treatment of erectile dysfunction. You are not alone.

A medical history and physical examination is an important part of the process for treating your erectile dysfunction. A thorough history can identify the risk factors (smoking, high cholesterol, medication side effects) that may have led to the problem. The history alone will be sufficient to explain most cases of erectile dysfunction. Laboratory tests may be needed identify less obvious causes of erectile dysfunction such as low testosterone.

A physical exam will identify problems such as Peyronies disease or prostate problems that may be contributing to your erectile dysfunction.

The following types of treatments are offered at Minnesota Urology:

Oral Medication

There are four current oral prescription medications for the treatment of erectile dysfunction – Sildenafil (Viagra®), Vardenafil (Levitra®), Tadalafil (Cialis®), and Avanafil (Stendra®). Which drug works the best? The drug that works best for you with the least side effects is the best. At Minnesota Urology, we often have samples of all of these medications.

These medications work by working with the natural chemicals in your body that help increase the blood flow to the penis giving you an erection. The medications enhance your normal blood flow. These medications do not work for all men, and may stop working over time if your erectile dysfunction becomes more severe.

Penile Self-Injection

Self-injection involves using a short, thin needle to inject medication directly into the spongy tissue of the penis. The medication increases the arterial blood to the penis giving an erection. A combination of several medications is often used in one injection.

Most men are very nervous about injecting medication into the penis. But for most men the injection itself is not painful and we take the time to instruct you in the office to make sure that you are doing the injections correctly. We will also instruct you to adjust the dose of medication so you inject only the amount you need to create an erection.

Most men find that penile injections are the next best alternative if the pills are not effective.

Muse® Urethral Suppository

Using a small plastic delivery system, a man inserts a small pellet down the end of the penis into the urethra. The medication is absorbed through the urethra into the erectile tissue giving an erection. This medication works for about 40-50% of men.

Vacuum Erection Devices

Vacuum devices work by manually pulling blood into the penis, creating an erection. Once created, the erection is maintained by pushing a rubber ring or “O-ring” onto the base of the penis, to maintain the erection. Vacuum pumps are easy to use and work regardless of the cause of your erectile dysfunction but may create a numbing feeling or discomfort after placing the O-ring.

Surgical Penile Implants

Penile implants involve surgical placement of bendable rods or inflatable cylinders into the penis. Once the surgery is healed the implants look and feel very natural. Because the implant is hidden inside the body, no one will know you have an implant other than your partner.

Inflatable prostheses are the most natural feeling of the penile implants. To produce an erection, a man pumps sterile fluid from a reservoir placed in his abdomen into cylinders placed in the penis by squeezing a pump in the scrotum. The cylinders expand to give a man an erection. When the erection is no longer desired, pushing a button on the pump allows the fluid to return to the reservoir.

Penile implants have a very high satisfaction for patients and their partners because the implant feels very natural and allow for full control over when and how long a man can have an erection.