Male Erectile Dysfunction

Treatment

• Injection Therapy
  A small needle is inserted into the side base of the penis and medication is directly injected into the erectile chamber of the penis. These medications vasodilate, or increase the blood flow to the penis.
• Oral Medications
  A number of prescription medications are available to improve blood flow to the penis and encourage erections. Oral drug therapy is generally the first option for men experiencing impotence. Some men who take nitrate medications for heart disease may not be candidates for oral medications despite being healthy enough for sexual activity.
• Urethral Suppositories
  MUSE is the trade name for prostaglandin suppository, a small pellet which is inserted in the opening of the urethra at the end of the penis. This medication absorbs into the tissue and allows an increase in blood flow to the penis.
• Vacuum Pumps
  A cylinder is placed over the penis and pump is used to create a negative-pressure vacuum which draws blood into the penis, creating an erection. A stretchable constriction band is placed around the base of the penis to prevent blood draining out and thus maintaining the erection.

• Penile Implant
  The penile implant may serve as a very satisfying, long-term solution to erectile dysfunction which does not respond to the above alternative therapies. The vast majority of implants are inflating-deflating types which employs a pump which is surgically placed into the scrotum. This type of implant allows for a hard, rigid erection which is fully controllable suitable for sexual intercourse at any time. This erection can be safely maintained for as long as desired. The inflatable penile implant provided full cosmetic concealment yet creates exceptional rigidity for sexual activity.

Frequently Asked Questions

• How long does it take to perform the procedure?

  The implant surgeries are generally performed under one hour. They are scheduled as outpatient procedures with the vast majority of patients returning home the same day. 

• Is the surgery under general or local anesthesia?

  The vast majority of men will undergo general anesthesia for this procedure, although a small majority will elect a spinal anesthetic.

• What follow-up appointments are scheduled?

  Depending on individual recovery, most patients are encouraged to start cycling and using their device as soon as possible, which can be anywhere from 2-4 weeks. There is generally a formal, post-operative visit at two months to assess healing and provide counseling regarding proper use of the device once the healing has been accomplished.

• What are the erections like with a penile prosthesis?

  A penile prosthesis provides a straight, hard erection for sexual intercourse. The sensation to the penis will be preserved. Sexual function and orgasm will be unaffected. If a patient has had a prostatectomy or other prostatic surgery and does not ejaculate, they will not ejaculate after a prosthesis either. Penile implants only improve erection quality. They do not improve reproductive function.

• Can anyone tell if a patient has an implant?

  Once placed, the penile implant is completely concealed an undetectable. No one will know unless they are told.

• Are there alternatives to surgery for impotence?

  Many men will attempt use of oral phosphodiesterase tablets such as sildenafil and tadalafil. Additionally, penile injections with vasodilators can be used along with vacuum assist devices and intra-urethral suppositories. Penile implant surgery is generally used when conservative measures have failed or have been unsuccessful.

• What is the life span of a penile implant?

  On average, an implant device will last 10-15 years with reasonable use. Many will last forever. Each implant comes with a lifetime warranty for replacement should the device fail. A replacement can be placed in the future if the device fails. 

• Is there any risk of placing a foreign body like an implant into the penis?

  In general, the only risk is a one percent chance of infection, which would require removal of the device. This risk is at the time of placement and not a long-term risk.

• What can patients expect post-operatively for recovery?

  Patients who have an implant should expect to have bruising and swelling after the procedure. This is common and normal. It is very important to ice the scrotum, elevate and maintain limited activity. We leave the implant in a partially inflated position to prevent scar tissue formation around the implant cylinders. Therefore, it is normal to have a partial or full erection for a number of weeks after the procedure. Showering is allowed, just towel dry the incision. No tub baths or swimming until the incision is healed. All sutures will dissolve and skin glue is used. There is nothing that needs to be removed from the wound post-operatively. 

• What symptoms should a patient call the emergency line for?

  Pus coming from the incision, hives, high fevers, trouble urinating or redness extending over the abdomen could be concerning signs or symptoms which we encourage patients to contact their doctor immediately.