Erectile Dysfunction Clinical Trial

If you have difficulty getting or maintaining an erection, you are not alone. One out of two American men between the ages of 40 and 70 are affected by erectile dysfunction (ED), formerly called impotence. ED is the inability to obtain or maintain an adequate erection for sexual intercourse. While more common in older men, it can occur at any age and is not a normal part of aging.  

Erectile dysfunction can cause emotional damage, a loss of self-worth, depression and negative self-image for patients and their partners. This problem can greatly impact the partners and the relationship as a whole. The good news is that virtually 100% of men can resume a normal sex life with one of the many therapies available. Our experienced urologists have helped thousands of men resume a satisfying sex life, and can respectfully and confidentially provide treatment that works for you.

Causes and Prevention
During sex, nerve impulses increase blood flow to the penis, causing an erection. Erection problems can be caused by a problem with blood circulation or nerve impulses to the penis, or by psychological issues that may affect performance, such as fatigue, stress, marital problems or depression.

ED can indicate an underlying medical problem such as:

• High blood pressure or atherosclerosis  (blood vessel plaques)
• Diabetes
• Hormonal imbalances
• Undiagnosed heart disease

ED also may be caused by smoking, obesity or drug use. To prevent ED, you should limit drug use, stop smoking, get regular exercise and adequate rest, and eat a balanced diet. Keeping a chronic medical condition such as diabetes under control also will help prevent ED.

Diagnosis
The first step is a thorough medical and sexual history and physical examination. Your doctor also may:

• Order lab tests to check your cholesterol and hormone levels, prostate health and other medical conditions
• Consider changing one of your medications to determine if that is causing your ED (do not stop any medications without consulting your physician.)
• Order an ultrasound, a painless test to check blood flow in the genital area

Treatment
Fortunately, a wide range of treatments are available. Your urologist can help determine which of these is right for you and your partner.

Oral Medications
A variety of medications are now available, including sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis). These medications work by relaxing the smooth muscles in the penis during sexual arousal, allowing increased blood flow. They have different doses, side effects and durations. Consult your doctor before taking them, as they are not appropriate for some patients with heart disease, especially those taking nitroglycerin.

Injectable Medications
When oral medications are not appropriate or unsuccessful, your doctor may recommend using alprostadil, a synthetic form of the hormone Prostaglandin E that relaxes the smooth muscles of the penis. You can inject this hormone into the side of your penis or place a tiny suppository into the tip of your penis (called MUSE).

Hormone Replacement
If lab tests determine that your testosterone levels are low, your doctor may recommend hormone replacement to improve your sex drive or further evaluation by an endocrinologist.

Vacuum Erection Devices
This treatment uses a mechanical device consisting of a hollow vacuum tube and rubber bands to draw blood into the penis and maintain an erection. The device is effective with few side effects.

Penile Implant
When other therapies fail, your doctor may recommend implanting a hydraulic mechanical device into your penis that allows you to inflate it when desired. You can choose one of several types of implants. Risks are low, while success rates and satisfaction are high.