Erectile Dysfunction

Erectile Dysfunction

Erectile Dysfunction (ED) is defined as the inability to obtain or maintain an erection for satisfactory intercourse. ED can be caused by psychological, vascular, anatomic or hormonal factors. Problems with low sexual desire, premature or prolonged ejaculation or pain with intercourse can be confused with ED and require specialized evaluation and treatment.

The part of the penis involved with erections is composed of two spaces similar to balloons called the corpora cavernosa.

When these spaces fill with blood, the penis becomes harder, longer and wider. 

Arteries bring blood to the penis and veins take the blood away. Nerves in the penis provide sensation and transmit signals to the blood vessels for filling and emptying.  Normal hormone levels are needed to keep these tissues healthy and functioning properly.

penis-cross-thumb

Having ED after prostate surgery for cancer is not uncommon.  The nerves related to erectile function lay along the area of the prostate and can be damaged during radical prostatectomy or by prostate radiation.

The evaluation of ED includes a complete history and physical exam and, in some cases, hormone testing is indicated.  Occasionally, penile ultrasounds or angiography may be necessary.   

Treatment

For most patients, the appropriate management of erectile dysfunction is the least invasive treatment that works.

pillsOral Medications

Most men with ED are initially treated with an oral medication such as Viagra, Levitra, or Cialis. Often, men who have not had success with these simply need better instructions.

For best effect, Levitra and Viagra need to be taken on an empty stomach and at least one hour prior to intercourse.

Cialis needs to be taken four hours before intercourse but its absorption is less affected by food. If testosterone levels are low, supplementation with testosterone can help these medications work.

Side effects of erectile medications including headache or heartburn can be treated with over-the-counter medications. Regular or potential use of nitrite medications is a contraindication for using any of the oral agents.  

MUSE - Alprostadil

MUSE is a small pellet of medication inserted into the opening of the urethra using an included disposable plastic applicator.  This medication is locally absorbed and promotes blood flow into the penis.

using-vedVacuum Pump Erection Device

A vacuum erection device is placed over the penis to create a vacuum and draw blood into the penis.

The device is removed and an elastic constricting ring is used to maintain the erection.

This treatment does not require medication or surgery and has few side effects if used properly.

Erectile Dysfunction Injections

ED treatment injection therapy involves a patient injecting a small amount of medication into the side of the penis using a small needle and syringe.

Patients are first taught exactly how to draw the medication into the syringe and perform the injection. They then demonstrate the ability to perform self-injection.

One to three trials in the office are done to determine the dose and strength to meet your individual needs. At this time, you are taught how to self inject under our supervision.

A specialty pharmacy, called a compounding pharmacy, can then be used to compound medication to match your unique needs.

penile prosthesisPenile Prosthesis

When non-surgical treatments fail or are not well tolerated, a penile implant remains an excellent option to restore the ability to have sexual intercourse. Several different types of implants are available and the type is matched with the needs and abilities of the patient.

A Malleable implant consists of two semi-rigid cylinders inserted into the penis to provide rigidity. These implants never change in size and can be bent or straightened. The advantage of the malleable device is the technical ease of insertion and ease of use.

A 3-Piece Inflatable implant is the most commonly used penile implant. Inflatable cylinders are placed in the penis and a pump is placed under the skin of the scrotum with a reservoir placed adjacent to the bladder. The 3 pieces are connected by tubing that transfers fluid between the components.

When a man wants to have penile rigidity, he squeezes the pump several times, and this causes a transfer of fluid from the reservoir to the cylinders leading to penile rigidity. There is also a release button to deflate the implant when not in use.

Both types of penile prosthesis are placed through a small incision near the base of the penis. The surgery can be done as outpatient with the ability to use the device in as little as six weeks.

Contact Us

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Round Rock Location

970 Hester's Crossing Road
Suite 101
Round Rock,TX 78681

Phone 512-238-0762
Fax 512-341-7370

 

Lakeline Location

12505 Hymeadow Drive
Suite 2C
Austin, TX 78750

Phone 512-238-0762
Fax 512-341-7370 

 

South Austin Location

4534 Westgate Blvd
Suite 108
Austin, TX 78745

Phone 512-238-0762
Fax 512-341-7370