Erectile Dysfunction

The discovery of PDE-5 inhibitors such as Viagra and Cialis was a truly revolutionary step forward in the treatment of erectile dysfunction, and nearly every man, and most women, are aware of its common usage.  That usage is so widespread because of the simple fact that impotence, or erectile dysfunction, is largely a matter of aging and in large part is inevitable to some degree in all men eventually.  Commercials project an image of a wonder-pill that restores a robust sex life.  What is not part of the marketing for pills is that they are effective roughly 70% of the time, and in reality, only work well for patients with only partial impotence.  This means that patients that suffer more severe organic impotence caused by medical problems such as diabetes and cardiovascular disease, as well as patients with erectile dysfunction as a result of surgery such as prostatectomy, are the least helped by PDE-5 inhibitors.  These patients are best served by either injection therapy or vacuum erection devices.

Injection therapy is the act of a man injecting medicine into his own penis to achieve an erection when he desires one.  Injections almost always work and are widely used although most men are not aware they exist as they are not marketed on television.  However, a closer look will reveal how mainstream they are.  If one sees an ad for an erection clinic in the newspaper or on the radio, these are clinics that basically just offer shots at a very high price under the premise that they are offering something not readily available.  However, all Urologists help their patients with injection therapy at a cost far less to the patient.

A vacuum erection device is a tube which is placed over the penis and pulls venous blood into the penis.  A constricting band is placed at the base of the penis to hold the blood in as a tourniquet would.  Such devices are readily available and economical and are a perfect solution for some.  However, patients can struggle with the device fitting properly, the suction can cause pain, and the female partner may complain that the erection feels relatively cold.  Also, vacuum erection devices are not very useful in the first six months after prostatectomy.

For all these reasons, Dr. Engel favors injection therapy for all those with severe impotence.  Vacuum erection devices are reserved for those that are needle-phobic or do not have the dexterity to inject themselves.  In these cases patients are advised to purchase a vacuum erection device on Amazon or a similar place, and to be sure to buy one that uses constricting bands, is medical grade, comes with instructions and support and seems professional in nature.