What to Do When Erectile Dysfunction Treatment with Penile Injections Does Not Work
If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5211.
We have excellent reviews from patients and their partners. Information for out-of-state and international patients. Find out our office hours or directions to our office.
We offer affordable appointment prices with or without insurance. Low-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.
Reasons Penile Injections Are Not Effective
Penile injections with PGE1 (prostaglandin 1) or Trimix (papaverine, phentolamine and prostaglandin E1) are among the most effective treatment options for erectile dysfunction.
Injectable medications in the penis often work when a medication such as Cialis stops working and Viagra does not work.
Most Common Reasons Why Penile Injections for ED Stop Working:
Incorrect administration of medications is the most common cause of why penile injections work in the doctor’s office but do not work at home. Penile injections of PGE1 such as Caverject and Trimix for ED should be administered deep inside the penis where the blood flow is (intra-cavernosal).
Often men do not insert the needle deep enough or inject at the wrong angle in the penis; as a result, medication is injected just below the skin and not deep enough to where it needs to be to cause an erection.
At New York Urology Specialists we make an effort to teach our patients proper injection technique, which is always successful for men if the medication is effective. Please schedule an appointment if you need help.
Medications used for penis injections for the treatment of erectile dysfunction come in two varieties: medications that require or do not require refrigeration. It is important to store medications properly especially when it comes to medications that require refrigeration. When medications that require refrigeration are not stored properly, they can lose their potency and may not work well. Prostaglandin is particularly volatile and can lose potency quickly.
An incorrect dose of medications for penile injections is used. Medications such as Bimix, Trimix, and QuadMix are custom-prepared medications mixed in compounding pharmacies. Formula and concentrations of each medication differ among compounding pharmacies.
As a result, medications are not interchangeable between different pharmacies. If a new pharmacy is used to order medications, office test injections in the physician office should be performed to make sure that the dose of medications is appropriate. At New York Urology Specialists, we perform test dosing for all our patients to make sure that the dose is both adequate and not excessive to avoid the risk of a prolonged erection that does not go away.
Common Reasons Why Penile Injections Do Not Work.
There are 2 primary causes of erectile dysfunction: Erectile dysfunction caused by arterial insufficiency and erectile dysfunction caused by corpora-venous occlusive insufficiency.
Penile injections work well for the treatment of erectile dysfunction caused by arterial insufficiency. A small number of men with severe arterial insufficiency may find that penile injections do not work well for them; for these men, a penile implant is usually the most effective treatment option.
Penile injections with medications such as Trimix often work for some men with mild corpora-venous occlusive insufficiency. For many men suffering from moderate to severe corpora-venous occlusive insufficiency, penile injections usually do not work. This is one of the reasons why penile Doppler ultrasound is a valuable test in determining the cause of erectile dysfunction and guiding a patient to appropriate treatment.
Men with Peyronie’s disease, especially with severe hourglass appearance, may find that penile injection such as Trimix and PGE1 E work well in the part of the penis toward the tip of the penis but do not cause an adequate erection in the part of the penis involved by the plaque that causes hour-glass appearance.
Men with Low-T (low testosterone) may find that the benefit of penile injections is reduced. Addressing low T may lead to an improvement in penile injection effectiveness for ED.
Options When Penile Injections are Not Effective
It is important that a patient is taught to inject medication such as prostaglandin E1 and Trimix correctly. In-office injection of medications to titrate to appropriate dose is an important component of treatment with penile injections and is recommended by the ED treatment guidelines from the American Urological Association.
For patients with low testosterone, testosterone replacement therapy is advisable. Similarly, patients with other hormonal abnormalities such as low or high thyroid levels or high prolactin levels should have hormonal abnormalities treated. Weight loss and treatment of high cholesterol and high blood pressure are important components of holistic treatment for erectile dysfunction.
Shockwave therapy for ED is a new treatment option for men with erectile dysfunction. Shockwave therapy may help some men with vascular erectile dysfunction for whom penile injections do not work well to regain the ability to use penile injections or oral medications for the treatment of ED.
Penile Implant is an Effective Alternative Treatment to Penile Injections
Usually, medications such as Viagra, Cialis and Levitra are tried prior to using penile injections. Most men progress to using penile injections for ED when an oral medication such as sildenafil (Viagra) does not work. Vacuum erection devices (VED) are an option but most men give up using VED after a short period of time due to inconvenience. Typically, vacuum erection devices did not work nearly as well as do penile injections or medication such as Viagra or Cialis.
The most reliable and effective treatment option for men for whom penile injections for the treatment of erectile dysfunction (Bimix, Prostaglandin E1, Trimix, and Quadmix) do not work is a penile implant. There are 2 types of penile implants: a malleable penile implant and an inflatable penile implant. Penile implants such as AMS 700 penile prosthesis and Titan Touch Inflatable penis prosthesis have high patient satisfaction. Penile implants work for men regardless of the cause of ED. Penile implants can help men with diabetes, high blood pressure and kidney failure among other problems to regain sexual function.
Dr. Alex Shteynshlyuger is among a small number of top urologists in the United States who perform penile implant procedures for men with erectile dysfunction, Peyronie’s disease associated with ED, as well as penile fibrosis caused by priapism.
Where to Get Treatment for ED in NYC?
At New York Urology Specialists, we offer specialized treatment for ED for men. Same-day appointments are available.
Call/text today: 1-646-663-5211 or make an appointment online.
We treat sexual and erection problems and offer comprehensive STD testing for infections. We treat penile problems in men, including phimosis, balanitis, penile irritation, and penile redness. We perform a no-scalpel vasectomy, vasectomy reversal, cosmetic circumcision, circumcision revision, penile frenuloplasty. We offer confidential appointments.
Our prices are ED treatment prices are affordable with or without insurance. Low-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients. We offer free insurance verification.
Read Real Stories of Men who Underwent Treatment for ED at New York Urology Specialists.
We offer ED treatment to patients within driving distance to our offices as well as from other states and countries. Our patients come from New York, New Jersey, Pennsylvania, and Connecticut, and over 30 countries worldwide.
- Read RealStories: 47-year-old with ED – Tadalafil Does Not Work
- Read RealStories: 52-Year-Old Man with Erection Problems Caused by Venous Leak (Veno-occlusive insufficiency).
- Read RealStories: 69-year-old Man Treated with Ambicor Penile Implant after Prostate Surgery for Prostate Cancer
- Read RealStories: 56-years-old diabetic treated with testosterone replacement therapy and Trimix
What do Penile Problems Look Like?
You can find pictures of penile problems including before and after treatment images in our image gallery.
What You Need to Know:
- Erectile Dysfunction in Young Men
- No scalpel vasectomy: Who is a good candidate?
- Why Cialis No Longer Works for You: Top 5 Reasons
- How Does Shockwave for ED Work? – Mechanism of Action
Why Choose New York Urology Specialists for Treatment of Erectile Dysfunction?
- All treatment is performed by a board-certified urologist experienced in treating men with symptoms of ED, premature ejaculation, and other sexual problems using medical therapy, minimally invasive therapies, lasers, and surgery.
- We are one of the few practices in the region to offer a full range of options for the treatment of sexual, and erection problems in men.
- We offer diagnostic testing in our office, which avoids hospital costs.
- Extensive Experience: Thousands of men have been treated successfully using medical therapy, shockwave therapy for ED, penile injections with Trimix, and penile implant surgery.
- Confidential and Understanding Care. We understand that most of our patients desire privacy. We see patients with a variety of urological problems. Your reason for visiting us is entirely confidential.
- We are one of the few practices in the region to offer a full range of options for the treatment of sexual and erection problems in men.
- We are conveniently located within a 30-60 minute commute to men who are seeking ED treatment in Manhattan, Brooklyn, Queens, Staten Island, Westchester, Long Island, Bronx, and New Jersey.
Scheduling Appointments for ED Treatment at New York Urology Specialists
If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5211.
We have excellent reviews from patients and their partners. Information for out-of-state and international patients. Find out our office hours or directions to our office.
We offer affordable prices with or without insurance. Low-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.
We offer weekday, weekend, and evening office hours.
Dr. Alex Shteynshlyuger is a board-certified urologist, who specializes in all aspects of care for sexual problems in men including ED, premature ejaculation, and other sexual concerns. He has successfully treated hundreds of men with sexual problems including ED and poor libido.
Patients Reviews
Overall Rating:5 |
Total Ratings5 |
Total Reviews68 |
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Urology by Alan on Jul 04, 2022Dr. Alex and all members of his staff are very attentive and professional. They are always willing to adjust to patient requests regarding scheduling and time. I’ve never had a negative experience when visiting the office and would highly recommend Dr. Alex and staff!
Circumcision and vasectomy by Hector Nieves on Feb 22, 2022Todo muy bien con el personal, la cirugia, el seguimiento, etc. Lo unico que podria decir un poquito negativo es el tiempo de espera despues de la hora de la cita fue bastante, pero con relacion a todo lo demas es excelente.
Review by Armando Santos on Dec 16, 2021Great experience
best urology doctor by Winston – via Healthgrades.com on Feb 14, 2021Dr Alex Shteynshlyuger is the best urology doctor there is. He is attentive, analytical, knowledgeable and skillful. Very confidential with a masterfully professional staff. I would not hesitate in recommending Dr Shteynshlyuger to the world because I am a satisfied patient of his.
solved my problem with ED by via HealthGrades.com on Jan 29, 2021Dr. Shteynshlyuger helped to solve my problem with ED
100% perfect circumcision by via HealthGrades.com on Jan 21, 2021Dr. Shteynshlyuger did what I would call an 100% perfect circumcision on me. I can’t even find my scar. He cut the precise right amount of skin. I now feel extremely happy, confident, and proud of how it looks. I am 100% satisfied with my results and I would recommend him to any guy seeking an adult circumcision. I healed in 5.5 weeks but his recommendation is 6 weeks to heal so that means zero “activity” for 6 weeks to avoid damaging the stitching. The surgical glue I pulled off at 5.5 weeks. It is important to not remove it before! The lower posterior of my shaft did not look good at first, especially w/ the surgical glue on it, but over weeks it looked better and better w/ the final results by 5.5-6 weeks being excellent When the doctor injected the anesthetic, it was painful since he must inject it deep ~6-8times. During the surgery my discomfort was maybe a 1/10, so tolerable. Make sure to buy lots of bandages/gauze before/after for daily change for 5-6 weeks
What went well
Appointment scheduling Office environment Staff friendliness Appointment wasn’t rushed Listened & answered questions Explained conditions well Trusted the provider’s decisions
What could be improved
Long wait times
Very Pleased by A. Pereira via Vitals.com on Jan 21, 2021Very Pleased, I couldn’t have asked for more from Dr. S as well as everyone in the office, The procedure and after was a dream with Dr. S. If you are on the fence, I can tell you, that you will love your experience with Dr. S
THEY TREAT YOU LIKE FAMILY by Luis via Google.com on Jan 11, 2021THEY TAKE GOOD CARE OF YOU AND THEY TREAT YOU LIKE FAMILY AND LOOK OUT FOR YOU
treatment from New York Urology by Anthony via Healthgrades.com on Jan 07, 2021My problem with ED is gone with my treatment from New York Urology!
What went well
Appointment scheduling Office environment Staff friendliness Wait times Appointment wasn’t rushed Listened & answered questions Explained conditions well Trusted the provider’s decisions
What could be improved
recommend Dr. Shteynshlyuger by via HealthGrades.com on Jan 04, 2021Yes I would recommend Dr. Shteynshlyuger . Effective physician at all levels.
finally able to enjoy life again by Josh via Google.com on Dec 16, 2020Dr. Alex absolutely changed my life and restored my faith in doctors. When my condition first started I saw four different urologists over a period of about 6 months. All four either laughed me out of their office saying there’s nothing they could do to help, that my pain was normal, or prescribed me something that did not help or made everything worse. I prepared to live my life (22 years old now) with chronic pain that made participating in every day activities extremely difficult. Finally after getting the courage to start looking for new doctors again I found Dr. Alex Shteynshlyuger and decided to give his office a call. I proceeded to see him shortly after my call, and now a few visits and months later I am finally able to enjoy life again. Dr. Alex took the time to do the tests that other doctors did not even mention. He took different approaches, gave well explained answers to all of my questions, and made me feel like there are some doctors who really do care. On top of all of that he has some of the most helpful and kind staff I have come across. I cannot stress enough how thankful I am for Dr. Alex!
No pain at all by Elson via Google.com on Nov 25, 2020This was a very fast and easy process. No pain at all and the job was very well done. He stays on top of your progress and helps to heal faster. I will definitely recommend Dr Alex at all times!!!
Great place by Yannis via Google.com on Nov 09, 2020Very friendly staff, A great experience from the front desk to seeing the doctor. Dr.Shteynshlyuger is very professional and makes you comfortable when you’re in the room. He answers every question with detail. Great place..
I would highly recommend it to anyone by Javier – Via Google.com on Oct 11, 2020I saw the reviews about this place and was very hesitant to go but something was telling me to go with them and I don’t regret it at all, the doctor did a great job and helped me understand the process plus the staff was amazing I would highly recommend it to anyone! quick story after the procedure I was in soo much pain and called the office on a SUNDAY, the doctor gave me a call back within 15 minutes and prescribed a stronger medication, to me that meant a lot for the doctor to take time from his day on a Sunday to help me.
highly qualified diagnostician by Vladimir via Google.com on Sep 23, 2020I have been observed by Dr. Alex for many years and I must say that he is a highly qualified diagnostician, and also several times I have received qualified microsurgical assistance and very useful advice. The only reason I put 4 with a plus is a somewhat long wait for the reception.
successful procedure by Grant via Google.com on Aug 20, 2020To Dr. Shteynshlyuger and your assistants and aids, thank you guys for a successful procedure. I’d refer you to others for your compassionate, knowledgeable, attentive service and indepth follow up care.
I am very happy with this doctor. by Maria via Google.com on Aug 12, 2020I am very happy with this doctor. He is very patient and he understood all my problems. He also answered my questions and gave me some good advice.
very friendly staff by via HealthGrades.com on Apr 12, 2020excellent doctor and all very friendly staff
2 years free of any UTI by Lucretia via Vitals.com on Apr 09, 2020This urologist has helped me for my constant UTI’s He gave me a few tests, diagnosed the problem and now I’m 2 years free if any UTI. A kind, intelligent, caring doctor LucretiaLaMura
Doctor Shteynshlyuger provided me with the care I needed by Christopher via Google.com on Mar 11, 2020The staff is very professional. Doctor Shteynshlyuger provided me with the care I needed. The wait, visits, and instructions were brief. I followed his instructions and my issue was resolved. As a patient exercise patience. Follow the instructions and be honest about your condition and what you hope to accomplish be visiting. Thanks again Doctor.
Patient review by Jose A La Luz on Jan 24, 2020
Buen doctor by Marcos perez on Jan 14, 2020Muy buen doctor. Y sobre todo el personal muy amable se preocupan por uno buen servicio
Thank you for your hlep by Ron on Dec 10, 2019Amazing doctor and staff. Thank you!
Shang Ring circumcision by via HealthGrades.com on Oct 29, 2019Overall, it was a good experience. Dr. Shteynshlyuger (Dr. Alex) was very nice, warm and helpful. He performed a Shang Ring circumcision for me and the procedure went well. I’m pleased with the results and there were no complications. If anyone is interested in the shang ring circumcision in the tristate area, then I’d recommend him. The whole procedure is $1850, which includes the initial consultation (provided that ther are no complications) and every follow up visit up to six months.
What went well
Appointment scheduling Office environment Staff friendliness Wait times Appointment wasn’t rushed Listened & answered questions Explained conditions well Trusted the provider’s decisions
What could be improved
Thank you doc !!! by via HealthGrades.com on Aug 14, 2019Great doctor, good bedside manner and always felt comfortable talking to him and the staff. Great location and affordable prices. Thank you doc !!!
What went well
Appointment scheduling Office environment Staff friendliness Appointment wasn’t rushed Listened & answered questions Explained conditions well Trusted the provider’s decisions
Office very convenient location by via HealthGrades.com on Aug 13, 2019Office very convenient location Don’t have to wait for long Staff very friendly Dr shteynshyuer very experienced I had my serviced done in 3 visits now I feel good now Than you Dr. shteynhlyuger
positive experience by via HealthGrades.com on Aug 09, 2019Dr. Shteynshlyuger is professional, knowledgeable, and experienced. I had a positive experience with him.
Peronis Disease by Robert Clarke on Aug 04, 2019Dr Alex was both knowledgeable and concise with his diagnosis and advice which was well received. Dr was her knowledgeable in the subject and provided good advice.
Review by Jim on Jul 26, 2019The staff are very friendly and efficient. Appointment ease is excellent. Dr. S. is terrific diagnostician, answers your questions quickly tries to assess how you are doing and focus on the purpose(s) of our visit Treatment alternatives are discussed . The longer you are a patient, the better the experience is.
3P Removal by Karl Henry on Jul 24, 2019Went to get my penile papule remove. Got done same day, it was fast, great staff, and most importantly, pleased with the result.
Recommendation by JOHN on Jul 18, 2019Therefore I would like to recommend you to anyone who need your services.
Urology Visit by Oliver on Jul 18, 2019Staff were all very welcoming. Dr. Alex Shteynshlyuger was very knowledgeable and attentive during my time spent with him.
Outstanding by Allan B. on Jul 09, 2019Went in for a procedure with Dr. Alex and he was very calm and thorough about the the operation and the recovery. From the front desk to his assistants, everyone was very courteous, professional and polite. I highly recommend NY Urologist Specialist. They are outstanding!!!
ED is Treatable in Nearly Every Man
At New York Urology Specialists, our urologists are specially trained in the evaluation and treatment of erectile dysfunction. We understand the challenges that ED creates for our patients, their relationships, and their self-esteem. We help you find a treatment for erectile dysfunction that fits your needs, lifestyle, and your preferences.
Urologists are doctors specializing in the treatment of men with erectile dysfunction. By virtue of our experience and skill, we are able to offer an effective treatment option for nearly every man who desires an effective treatment for ED. We offer medical and surgical treatment for erectile dysfunction.
We Treat Some of the Most Complex ED Problems Including:
- Erectile dysfunction in men with prostate cancer after radical prostatectomy
- Impotence in men with diabetes.
- Erectile dysfunction in men with Peyronie’s disease
- Erectile dysfunction in men for whom medications do not work.
- Erection problems in men with low testosterone.
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If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5211.
We have excellent reviews from patients and their partners. Information for out-of-state and international patients. Find out our office hours or directions to our office.
We offer affordable appointment prices with or without insurance. Low-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.
We offer weekday, weekend, and evening office hours.
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