Erectile Dysfunction

Treatment

Once the underlying cause for a patient's erectile dysfunction (ED) is identified, proper treatment can be selected. Urologists at Mayo Clinic offer the latest advances in medications, penile implants, vascular therapy, mechanical devices and psychological counseling.

Medications

Currently a variety of PDE-5 inhibitors are used to treat ED. These include Sildenafil (Viagra), Tadalafil (Cialis) and Vardenafil (Levitra). Dosages, duration of effectiveness and possible side effects vary, but the medications all work in much the same way. The drugs, known as phosphodiesterase inhibitors, help relax the smooth muscles of the penis. Specialists at Mayo Clinic determine the appropriateness of a medication based on each patient's medical condition.

For men who cannot take PDE-5 inhibitors, Mayo Clinic offers other drug treatments, including various penile injection therapies. One such drug, called alprostadil, is a synthetic version of the hormone prostaglandin E. This drug can be injected at the base of the penis or administered via a suppository placed into the tip of the penis. Mayo urologists work closely with patients to help them learn proper administration techniques that will minimize the risk of side effects.

For a small percentage of men, testosterone replacement therapy may help to alleviate the symptoms of ED.

Penile Implants

For the 5 to 8 percent of men who have unsatisfactory results with drug treatment, Mayo Clinic urologists can provide penile implants. Mayo Clinic urologists perform 80 to 100 penile implants annually, achieving a high success rate with minimal complications. Penile implants are small rods or inflatable devices implanted in the penis that can be manipulated to create an erection.

Vascular Therapy

If a patient suffers from vascular blockages caused by injury to the penis or pelvis, vascular surgery may be considered to correct ED.

Mechanical Devices

Vacuum devices can be used to force blood into the penis that initiates an erection. A tension ring can then be tightened at the base of the penis to maintain the erection during intercourse.

Psychological Counseling

If urologists determine that a patient's ED may be related to stress, anxiety, depression or other psychological conditions, they may refer a patient to a Mayo psychologist or psychiatrist who has experience treating patients with sexual problems.