Erectile dysfunction (ED) is a medical term that describes the inability to achieve and or maintain an erect penis adequate for sexual function. This condition is one of the most common sexual problems for men and increases with age. It is estimated between 15 to 30 million American men suffer from ED, although not all men are equally distressed by the problem.
Erectile Dysfunction can be:
- A total inability to achieve an erection – You can never get an erection.
- An inconsistent ability to do so – You can only occasionally get an erection.
- A tendency to sustain only brief erections – You can get an erection, but can’t keep it long enough for satisfying sex.
As a result of recent medical research, it is now known that more than 80% of men suffering from E.D. can trace its origin to a physical problem or disorder
- Certain Medical conditions
- Tobacco use
- Medical treatments
- Psychological Conditions
- Drug and Alcohol use
Trouble having or maintaining an erection
Most doctors will ask many questions to try and diagnose why you might be experiencing erectile dysfunction. Some ways to help diagnose this may include:
- Questions about health problems
- Questions about your history of Erectile Dysfunction
- Questions about stress and emotional health
- Physical exam
- Lab test
Treatments will vary depending on the cause of your erectile dysfunction. All decisions regarding your best option for treating E.D. should be made between you and your physician, with consideration given to your individual needs and the pros and cons of each treatment options.
The treatment options include:
- Drug Therapy
- Non-drug Treatment Options
- Penile Implants
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-Dr. Will Flanagan
Dr. William F. Flanagan M.D. is recognized as an expert in treating Erectile Dysfunction by Coloplast Men’s Health. GHS Regional Urology is the only center in the state of South Carolina that has been given a Center of Excellence designation for the treatment of erectile dysfunction.
Dr. Blake Wynia completed his medical training at University of North Carolina at Chapel Hill School of Medicine, followed by a residency at New York University in New York, NY, and a Fellowship in Andrology and Male Genitourinary Reconstruction from Albany Medical College, Albany, NY. Dr. Wynia is now seeing patients at Regional Urology.
He specializes in male infertility, hypogonadism, erectile dysfunction, peyronie’s disease, benign prostatic hyperplasia, and nephrolithiasis.
DON’T blame yourself.
- If you’re the partner of a man struggling with E.D., you may tend to blame yourself first. You may think it’s your fault, that maybe your partner isn’t attracted to you any longer. You often don’t realize that your partner’s E.D. is caused by a medical reason.
DO your homework.
- Many people view E.D. as a sexual issue, when in fact, it’s usually a physical one. Conditions such as diabetes, high cholesterol, or early-stage heart conditions can all contribute to E.D. Even certain medications can bring on E.D. The faster you realize that this is a medical condition affecting your partner’s body, the faster the healing can begin.
DON’T approach the issue with negative emotions.
- A man with E.D. will often experience deep feelings of shame, loneliness, anxiety and depression. He will often say that the inability to have an erection makes him feel like less of a man. In fact, he may be hesitant to kiss or cuddle you because he is embarrassed about where it might lead. Confronting him with feelings of hurt or anger may make him feel attacked, so he may withdraw even further.
DO open the lines of communication.
- Have a conversation with your man – but not in the bedroom. Put some time and space between your conversation and your last sexual encounter. Make your partner aware of the health conditions that can cause E.D., and gently suggest he see his doctor. He may ask you to join him at his appointment, or he may prefer to have a private conversation with his physician. Let him decide.
DON’T tell him that his E.D. doesn’t matter.
- Some partners think they are being helpful by saying their partner’s E.D. isn’t a big deal. It matters deeply to him, and suggesting otherwise sends the message that you don’t miss intimate, sexual contact with him, which can be very hurtful.
Drugs for treating erectile dysfunction can be taken orally, injected directly into the penis, or inserted into the urethra at the tip of the penis. The most commonly known drug on the market today is Viagra®.
There are several prescription medications that claim to help patients
Some patients may experience side effects, including:
- Facial blushing
- Upset stomach
- Mild and temporary visual effects
Some men may be able to gain an erection by self-injecting drugs into the penis, causing it to become engorged with blood.
The advantage of injection therapy is:
- It can easily be self-administered
Potential side effects of injection therapy include:
- Fibrosis (scarring)
- Long-lasting painful erections
Injections are shown to have a long-term dropout rate of 37% – 76%1 . Reasons for dropping out of drug therapy include:
- Desire for a permanent treatment alternative
- Inadequate response
- Return of spontaneous erections
- Fear of needles
- Concern over side effects
Other treatment options for Erectile Dysfunction
Your doctor can provide you with specific details about the pros and cons of each of the following treatments:
- Lifestyle changes like stopping smoking, losing weight and eating healthier
- Oral testosterone
- Intraurethral suppositories (ex. MUSE®)
- Vacuum devices
Some men find that the treatment options listed above are not suitable for them due to medical conditions, lifestyles, personal preference, or the treatment option may be ineffective. In this case, a penile implant may be an appropriate option.
- Approximately 30 million American men suffer from erectile dysfunction 4 .
- Most men with erectile dysfunction still have the ability to have an orgasm and father a child, but often have difficulty doing these things because they can’t get or sustain an erection.
- Erectile dysfunction is not normal, and is by no means an inevitable consequence of aging.
- Most men at one time or another during their sexual lives are unable to get or keep an erection. This is normal and does not indicate a problem. However, millions of men of all ages experience this inability as a continuing problem.
- In most cases, erectile dysfunction can be overcome.
The penis has two chambers inside it called the corpora cavernosa. These chambers extend from the head of your penis deep into the pelvis. The insides of these chambers are made of spongy tissue and have the ability to gain blood volume and grow in size.
During your daily activities, the arteries that supply blood to the penis are only partially open, to allow enough blood flow to keep your tissue healthy.
When you experience sexual stimulation, the brain sends signals to trigger a hormonal response that allows those same arteries to open completely.
Those open arteries allow more blood to enter the corpora cavernosa faster than the blood can leave through the veins. As the corpora cavernosa fill and grow in size, the veins get compressed, trapping blood in the penis, causing it to get stiff. This chain reaction continues until you achieve and maintain an erection.
When your brain stops sending signals, the hormones diminish and your arteries go back to their normal state.
E.D. problems begin when our brain doesn’t send enough or any signals, when the blood flow is inadequate, or when erectile tissue is damaged.
1) Sexual stimulation and excitement cause the brain, nerves, heart, blood vessels and hormones to work together to produce a rapid increase in the amount of blood flowing to the penis.
2) The blood becomes trapped and held in the two spongy chambers in the shaft of the penis.
3) As the chambers rapidly fill with blood, they expand, and the penis becomes firm and elongated. The result is an erection.
A penile implant is a device that is placed into a man’s body and is designed to help him get an erection. Get the facts on an alternative long-term treatment, that is covered by many insurance plans, which allows an erection as often as you like, for as long as you wish.
There are two basic types of penile implants:
- The Titan Touch® and Titan® OTR inflatable penile implant
- The Genesis™ flexible rod penile implant
Both enable men with erectile dysfunction to have a satisfactory erection for sexual intercourse and to experience the joys of sex again. You should be able to have an orgasm with a penile implant if you were able to have one before your surgery, unless you have another medical problem that affects it. Consult your physician about this. The primary difference between the two implant types is that flexible rod implants (the Genesis) produce a permanently firm penis, while the inflatable implants (the Titan) produce a controlled, more natural erection.
Some facts about Coloplast’s penile implants:
The Coloplast Titan Touch inflatable penile implant is a self-contained, fluid-filled system made from Bioflex and silicone. Bioflex is a supple, durable biopolymer material.
- The only IPP with a true lockout valve located at the base of the reservoir
- Designed to emulate the look and performance of a natural erection
- Pump design has a non-bulky, low-profile size
The Titan Touch inflatable penile implant offers a dependable method of restoring sexual function.
- It is the result of advanced engineering and medical research designed with your needs in mind
- It offers hope to many men with E.D.
- It provides an option where other treatments are not appropriate or have failed
Patient satisfaction rates
- 98% of patients were moderately or completely satisfied with their penile implant choice, far outpacing satisfaction levels for Viagra (51.6%) or injection therapy (40.9%)1 .
Mechanical reliability rates
- Recent studies show the Coloplast Alpha 1 and Titan to have mechanical reliability rates of 97.5% after five years on first time implants 2 .
- When implanted, the Coloplast Titan penile implant is not visibly noticeable. The penis appears relaxed and normal in the flaccid state, and it is not obvious by looking at a man that he has an implant.
Lifetime replacement policy
- Coloplast provides a lifetime replacement policy with all of its penile implants. Coloplast will replace the inflatable implant, or any component, for any reason during the lifetime of the patient.
Frequently asked questions
Will I lose any length after getting a penile implant?
- Each penile implant is custom fitted to your anatomy. Discuss this in greater detail with your physician.
Will I be able to have spontaneous erections with a penile implant?
- In order to place the implant in the body, the corpora containing the spongy tissue is removed to make room for the cylinders. If you are still able to have erections on your own, which are satisfactory for intercourse, you should consider very carefully whether or not an implant is the right fix for you. However, if you cannot have erections or if they are not satisfactory for intercourse, then an implant will be able to provide you with a more “instant” erection when compared to pills, or vacuum devices.
What is the recovery time?
- Each individual is different and therefore their recovery will be different as well. Typical recovery is between 4-6 weeks. Your physician will determine what you can and cannot do during this time. It is important to follow the recommendations that your physician gives to you to ensure the best outcome.
Is the cost of a penile implant covered by insurance?
- A penile implant is prescribed by your physician. Most insurance, including Medicare, cover the implant. Check with your physician’s office to determine your actual cost.
What makes the Genesis® and Titan® Touch different?
- Both implants provide you with the capability of having an erection satisfactory for intercourse. The main difference is that the Genesis penile implant is a malleable implant consisting of 2 rods that are placed in the corpora cavernosa. There are no further parts to this implant. To have an erection, you only need to hold the penis and move it into the desired position. When you are finished you return the penis to the previous position. With the Titan Touch penile implant, you inflate the cylinders by pressing the pump bulb in the scrotum. You can control the firmness by pumping until you are satisfied with the erection. The best thing is to discuss each implant with your physician to make sure that you are getting the implant that is appropriate for you.
Are there risks associated with the penile implant?
- As with any surgery, there are some risks associated with the penile implant procedure including pain, anaesthesia reactions, repeat surgery due to infections, or mechanical problems with the device. Discuss this in greater detail with your physician.
Will anyone notice that I have an implant?
- Since the implant is completely placed inside your body, no one will see the implant. In fact, no one will know unless you tell them.
Can I have an orgasm with a penile implant?
- You should be able to have an orgasm with a penile implant if you were able to have one before your procedure. Consult your physician about your expected outcome.