Medications form the first line therapy for the management of ED. These agents work by causing a dilatation of blood vessels which supply the penis, facilitating an increase in length and girth in the context of sexual stimulation. These medications are relatively well tolerated in the majority of men, there are however, some common side effects. These include headache, flushing, visual changes, indigestion and back and leg pain. These drugs need to be taken between one to several hours prior to planned sexual activity. Although efficacious in many, there will still be around 20-30% of men in whom there will be no or an inadequate response.
Intracavernosal Injection Therapy
The patient or his partner uses a needle to inject medication directly into the base of the penis. The relaxation of muscle tissue allows blood to flow into the penis, creating an erection. This treatment can be more effective than oral medicines but can be associated with painful erections which may result in many men discontinuing use within the first year.
Surgical Treatments: Penile Implants
If drug treatments, injections and other non-surgical therapies are not successful in resolving ED, and psychological causes are not suspected, the next treatment option includes penile implant surgery. Penile implants have helped many men return to an active sex life, and studies show high satisfaction among patients and their partners.
A penile implant (also called a penile prosthesis) is concealed entirely within the body, and requires a degree of manipulation before and after intercourse to make the penis erect or flaccid. There are different types of implants based on the manner of operation, naturalness of the erection and the number of components implanted. In choosing a penile implant, considerations include medical condition, lifestyle, personal preference and cost.
Penile implants can provide a natural appearing erection and greater flaccidity than two-piece or malleable implants. These advanced, three-part prostheses are inflatable implants available in a variety of models and sizes for a custom fit. Each consists of a reservoir implanted in the abdomen, a pump placed in the scrotum and a pair of cylinders implanted in the penis. The entire device is totally concealed in the body.