Erectile Dysfunction (ED) Treatment Options – New York Urology Specialists

If you experience ED, it is important not to ignore the problem and to get a prompt evaluation for ED from your doctor. If you don’t see your doctor, these problems will go undetected and untreated. 

When it comes to treatment of erectile dysfunction – New York Urology Specialists are a step ahead.  The causes of ED are complex.  ED is often a symptom of other medical conditions.  Dr. Alex Shteynshlyuger is a specialist in treating erection problems using latest scientific and medical breakthroughs.

If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call 1-(646) 663-5211.

Specialists in Treatment of Impotence

Treatment for ED in NYC

Understanding Treatment for Erectile Dysfunction

More than 18 million men in the US suffer from erectile dysfunction (ED), commonly known as impotence. The prevalence of ED is higher in middle-aged and older men, but it can affect men as young as 20.

Erections depend on good blood flow to the penis. When men experience erection problems such as erections that are not hard enough or erections that do not stay up, the underlying problem is blood flow.

Problems with blood flow can occur as a result of medical problems such as high blood pressure, low testosterone or diabetes. There are two major causes that prevent men from getting great erections: (1) inadequate blood flow to the penis also known as arterial vascular disease, and (2) venous leak erectile dysfunction caused by the failure of the erection maintenance mechanism.  Underlying depression and anxiety can cause situational ED through a different mechanism. Some prescription medications cause ED as a side effect.

An occasional inability to get or maintain a firm erection is not a cause for alarm. This could be the result of general tiredness or of having had one drink too many. If this is a more persistent problem, however, there are treatments available. Treatment options for impotence in men include lifestyle changes, medications, mechanical vacuum erection devices, penile injections, and 3-piece inflatable penile implants.

Medical Evaluation in Men with Impotence

Prior to starting any therapy for ED, a comprehensive medical evaluation is necessary to look for treatable causes of impotence which may include hypertension (high blood pressure), diabetes, low testosterone, abnormal thyroid function, and many other conditions.

At New York Urology Specialists, we ask all patients to provide a comprehensive medical and social history. You may fill it out at home.  You can expect a thorough physical exam and blood work which may include hormonal evaluation (testosterone, thyroid gland testing (TSH), and lipid profile (cholesterol/triglyceride testing) at a minimum. Blood work needs to be performed in the morning on an empty stomach.

Some men may require additional testing depending on our findings which may include penile ultrasound with doppler.

Treatment Options for ED include:

Medications: Viagra, Cialis, Levitra, and Stendra

Oral medications such as Viagra (sildenafil), Levitra (vardenafil) or Cialis (tadalafil) are usually the first line of treatment. They are effective in more than 85% of men.  If oral medications do not work well, other options that include injection of medications in the penis, vacuum pump, and penile implant are available.

Nonsurgical treatment alternatives include vacuum erection devices and penile self-injections.   Vacuum erection device works well for many men but long-term satisfaction is low. Self-injection of medications such as prostaglandin or trimix into the penis is also effective for many men.    These treatments are not effective for all men. Some men find these options inconvenient. Dissolvable medications and chewing gum are available in some countries but not FDA approved and not available in the US.

Intraurethral alprostadil (MUSE): is a small pill inserted in the urethra (pee hole) which produces an erection within 5-10 minutes.  MUSE is not a popular choice among men as it is expensive and not very effective.

Intracorporeal Injection Therapy (ICI): using a small needle medication such as prostaglandin or Trimix is injected into the penis. This produces an erection within 5-10 minutes that can last around 1 hour.  Injection is almost painless.

Shockwave Therapy for ED

Shockwave therapy for treatment of erectile dysfunction is a fairly new treatment option. Shockwave for ED has been shown to be effective in rigorous scientific studies. Shockwave therapy can be used in place of medications such as Viagra and Cialis (tadalafil), or in addition to medications such as sildenafil (Viagra).  Shockwave therapy does not cause any side effects unlike oral pills which makes it a popular choice for men who cannot tolerate side effects of medications such as Viagra or Cialis or for whom medications do not work well.

Penile Implant

Penile prosthesis implantation offers effective treatment for ED for men who do not respond to oral medications and for whom vacuum or ICI either do not work or do not provide adequate satisfaction.  For these men, prosthesis implantation offers effective treatment for erectile dysfunction.

A three-piece inflatable penile prosthesis is a fluid-filled inflatable device consisting of two penile cylinders, a scrotal pump, and an abdominal fluid reservoir.  AMS-700 inflatable penile implant has a very good track record and high patient satisfaction.  Similarly, Coloplast Titan inflatable penile implant offers many years of service for many men.  

Treatments that Do Not Have Scientific Evidence that They Work

Certain treatments are offered to men for treatment for erectile dysfunction without strong scientific evidence from long-term randomized controlled studies that they work. These treatments include stem cell therapy for ED, and PRP, or platelet-rich plasma therapy also marketed as Priapus shot.  


Schedule an Appointment with Dr. Shteynshlyuger:

Call today: (646) 663-5211 or make an appointment online

Dr. Alex Shteynshlyuger is a fellowship trained board-certified urologist with expertise in evaluation and treatment of urological problems in men using modern effective and proven treatment methods.  He is highly recommended by top primary care physicians in the New York area.

He has successfully treated men with sexual problems that include erectile dysfunction, premature ejaculation, pain in the penis, penile curvature and low testosterone.

If you or someone you know has been experiencing urological symptoms, make an appointment to take advantage of Dr. Shteynshlyuger’s expert advice. Please feel free to Contact Us with any questions.

What You Need to Know:

Over-the-counter herbal preparations are sold in many stores and gas stations.  There is no scientific evidence that these work.  However, some of the herbal preparations that have worked well were found to have active prescription medications illegally mixed in.  Please be careful as these can actually be dangerous for some men for example if they are taking nitroglycerin.

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What You Need to Know:

If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call 1-(646) 663-5211.

Doctors at New York Urology Specialists are experienced in discussing ED.  You can be comfortable with the knowledge that your needs will be taken seriously. ED can be a sign of serious health problems including vascular and neurologic problems. ED can be caused by a build-up of cholesterol in your blood vessels. Diabetes can cause nerve damage and blood vessel damage that may lead to ED.


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