Erectile Dysfunction (ED) Treatment Options – New York Urology Specialists
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:
- Behavior Modification and Prevention: Weight loss, treatment of medical problems such as diabetes, high cholesterol, etc.
- Medications (oral pills, intraurethral pills, and injectable medications)
- Surgery (Penile Prosthesis)
- Vacuum pump
- Shockwave for Erectile Dysfunction
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. The injection is almost painless.
Shockwave Therapy for ED
Shockwave therapy for the 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 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.
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.
Learn More About:
- Penile Implant (Inflatable Penile Prosthesis) for Treatment of ED – New York Urology Specialists
- Shockwave therapy for ED in NYC (EDSWT with MediSpec1000 and Renessa)
- How is ED Diagnosed? – New York Urology Specialists
- Top 5 Causes of ED
What You Need to Know:
- What to do If Cialis and Viagra Do Not Work
- Erectile Dysfunction in Young Men
- How do Erections Occur? What Causes ED in Men?
- How is ED Diagnosed? – New York Urology Specialists
- Top 5 Causes of ED
Scheduling Appointments for ED Treatment at New York Urology Specialists
by Winston on Sep 15, 2018
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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, your lifestyle and your preferences.
Urologists are doctors specializing in the treatment of men with erectile dysfunction. By the 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 Viagra and Cialis do not work.
- Erection problems in men with low testosterone.
Schedule an Appointment with Dr. Shteynshlyuger:
Dr. Alex Shteynshlyuger is a fellowship trained board-certified urologist with expertise in evaluation and treatment of sexual and erection problems in men using modern effective and proven treatment methods. We offer inflatable penile implant, shockwave therapy for ED and treatment for Peyronie’s disease.
He is highly recommended by top primary care physicians in the New York area. 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.
We offer affordable, highest-quality urology care with or without insurance. Find out our office hours or directions to our office. We offer weekday, weekend and evening office hours.