A patient asked me yesterday about the options to treat his ED. Here is, in essence, what I told him.
1: Medical Therapies: These are the PDE5 inhibitors, viagra, cialis, and levitra. All 3 work quite well, in general, and each have their own unique qualities. Some patients will respond well to one, but not to another. Similarly, some patients will experience side-effects with one agent, yet not another agent. In general, these medications are good first line therapies.
2: Injection therapies: This is a very effective form of treatment that works >90-95% of the time. It involves the man injecting a tiny needle into the base of his penis 10-15 minutes before he wishes to engage in sex. The injection is painless and most find men have no problem learning how to perform the injections. However, the majority of men who start to use injection therapy will ultimately discontinue it for a variety of reasons.
3: Penile implants: This is the most effective form of treatment for ED and the only one that allows for the patient's return to normal functioning. It involves the urologist placing a small pump into the scrotum via a small opening in the skin. When the man desires an erection, all he does is press on the pump and sterile water transfers into the penis and he gets a normal, firm erection that will stay up as long as he desires. Men who have this procedure done report the highest satisfaction levels, though it is the most invasive form of treatment and it has side-effects.
4: Other options: Other options exist, though they really do not work well or any better than placebo, so I don't recommend them.
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