Materiały źródłowe

• #1 Treatment for Erectile Dysfunction – NIDDK

  https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment

  Health care professionals treat the underlying cause of erectile dysfunction (ED) when possible. […] Health care professionals may suggest counseling if mental health or emotional issues are affecting your ED. […] Health care professionals may also prescribe other types of medicines for your ED. […] Phosphodiesterase type 5 (PDE5) inhibitors are oral medicines that improve blood flow to the penis. […] If you have ED and low testosterone, health care professionals may prescribe testosterone with PDE5 inhibitors. […] Injectable medicines and suppositories can enhance erections. […] Some people say certain alternative medicines help their ED symptoms. […] Vacuum erectile devices (VEDs) pull blood into the penis for an erection. […] If you have tried all other options and your ED does not improve, you and your health care professional may consider surgery to implant a device called a prosthesis to make the penis erect.

• #1 Erectile Dysfunction Treatment & Management: Approach Considerations, Pharmacologic Therapy, External Erection-Facilitating Devices

  https://emedicine.medscape.com/article/444220-treatment

  Angioplasty or stent placement may be used for ED due to focal atherosclerotic stenosis of arteries supplying the penis. In patients with ED due to veno-occlusive dysfunction, transcatheter embolization may be used to occlude venous leaks. […] An increasing array of medications is available to assist in the management of ED. New agents are still undergoing clinical testing, and more are in the early phases of development. […] In current practice, PDE5 inhibitors are the most commonly used treatment for ED. […] This drug class consists of sildenafil, vardenafil, tadalafil, and avanafil. […] Guidelines from the American Urological Association (AUA) recommend offering PDE5 inhibitors as first-line therapy for ED unless the patient has contraindications to their use (eg, concurrent organic nitrate therapy).

• #1 List of 12 Erectile Dysfunction Medications Compared

  https://www.drugs.com/condition/erectile-dysfunction.html

  Medications for Erectile Dysfunction […] A consistent inability to sustain an erection sufficient for sexual intercourse. Also commonly known as impotence. Medically, the term erectile dysfunction is used to differentiate impotence from other problems that interfere with sexual intercourse. […] The medications listed below are related to or used in the treatment of this condition. […] Cialis to treat Erectile Dysfunction […] sildenafil to treat Erectile Dysfunction […] Viagra to treat Erectile Dysfunction […] tadalafil to treat Erectile Dysfunction […] Caverject Impulse to treat Erectile Dysfunction […] vardenafil to treat Erectile Dysfunction […] alprostadil to treat Erectile Dysfunction […] Edex to treat Erectile Dysfunction […] Stendra to treat Erectile Dysfunction

• #1 Sexual Health & Erectile Dysfunction | Mount Sinai – New York

  https://www.mountsinai.org/care/urology/services/mens-health/male-sexual-dysfunction

  The treatments we use most often include: Lifestyle changes, Oral medications, Hormone replacement therapy, Counseling, Intraurethral agents, Penile injection therapy, Vacuum Erection Devices, Penile implants, Reconstructive surgery. […] We understand that deciding on a treatment is highly personal. We provide expert guidance to help you and your partner choose the best option for you. […] Oral medications include Viagra® (Sildenafil), Cialis® (Tadalafil), and Levitra® (Vardenafil). These medications improve blood flow to the penis by working directly on the blood vessels. They allow your arteries to expand, which can produce an erection. […] You usually need to take a pill about one to three hours before planned sexual activity. Sexual stimulation is also necessary to provide an erection. Drug treatments have been found to be successful for 70 percent to 80 percent of men.

• #1 Erectile Dysfunction Treatment & Management: Approach Considerations, Pharmacologic Therapy, External Erection-Facilitating Devices

  https://emedicine.medscape.com/article/444220-treatment

  The AUA warns that PDE5 inhibitors can cause mild transient systemic vasodilation, which may be aggravated by alpha-blocking agents. […] In patients with ED that is refractory to therapy with oral PDE5 inhibitors, one of these agents can be combined with an injection of prostaglandin E1 (PGE1; alprostadil). […] Men who present with diminished libido and ED may be found to have low serum testosterone levels (hypogonadism). Hormone replacement may benefit men with severe hypogonadism and may be useful as adjunctive therapy when other treatments are unsuccessful by themselves. […] Replacement androgens are available in the following four forms: Oral, Injectable, Gel, Transdermal. […] The modern age of pharmacotherapy for ED began in 1993, when papaverine, an alpha-receptor blocker that produces vasodilatation, was shown to produce erections when injected directly into the corpora cavernosa.

• #1 Management of Erectile Dysfunction | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/0201/p305.html

  Erectile dysfunction (ED) is the most common sexual problem in men. […] First-line therapy for ED consists of lifestyle changes, modifying drug therapy that may cause ED, and pharmacotherapy with phosphodiesterase type 5 inhibitors. […] Phosphodiesterase type 5 inhibitors are the most effective oral drugs for treatment of ED, including ED associated with diabetes mellitus, spinal cord injury, and antidepressants. […] Testosterone supplementation in men with hypogonadism improves ED and libido, but requires interval monitoring of hemoglobin, serum transaminase, and prostate-specific antigen levels because of an increased risk of prostate adenocarcinoma. […] Cognitive behavior therapy and therapy aimed at improving relationships may help to improve ED. […] First-line therapy for erectile dysfunction should consist of oral phosphodiesterase type 5 inhibitors.

• #1 Erectile dysfunction: Nonoral treatments

  https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/in-depth/nonoral-erectile-dysfunction-treatments/art-20045578

  Medicines taken by mouth aren’t the only ways to treat erectile dysfunction. Know the full range of treatment options and how they work. […] But oral medicines aren’t safe or effective for everyone with ED. If that’s the case for you, your doctor or other health care professional might recommend nonoral treatments. These don’t involve taking erectile dysfunction medicines by mouth. […] Nonoral medicines for erectile dysfunction are the kinds that you don’t take by mouth. They include: […] Self-injections. These are shots of medicine that you give yourself to get an erection. You use a fine needle to inject a prescription drug into the base or side of your penis. […] Alprostadil urethral suppository (Muse). This is a tiny, medicated pellet, called a suppository, that goes inside your penis.

• #1 Treatment Options for Erectile Dysfunction – North Alabama Urology, PC

  https://www.northalaurology.com/mens-health/treatment-options-for-erectile-dysfunction/

  Pills like Viagra™, Cialis™, Levitra™, or Stendra™ may help achieve erections in response to stimulation. They generally should be taken at least half an hour to one hour before anticipated sexual activity. Potential side effects include headaches, facial blushing, upset stomach, back pain/muscle aches, and nasal congestion. […] A penile injection is placed into the penis to inject medication to create an erection. This produces an erection within 5-20 minutes. Potential side effects include priapism (erection lasting 4 hours or more), penile pain, numbness or irritation, bruising at the injection site, and penile fibrosis (deformed penis shape). […] Vacuum erection devices are external pumps placed over the penis to help with ED. The device, consisting of a cylinder and pump, creates a vacuum that pulls blood into the penis creating an erection and a constriction ring that helps maintain the erection. Patients who use vacuum erection devices may experience penile discomfort, penile numbness, and an erection that is not warm to the touch, among other potential side effects.

• #1 Vacuum therapy in erectile dysfunction—science and clinical evidence | International Journal of Impotence Research

  https://www.nature.com/articles/ijir20104

  VCD therapy can be applied successfully for nearly all etiologies of ED; although its success depends on appropriate instruction and practice. […] More than 90% of men will experience functional erection with VCD therapy with adequate practice. […] It is currently a second-line therapy along with intracavernosal self-injection and intraurethral therapy with vasoactive substances. […] VCD may also be used in conjunction with other therapies for synergistic effects. […] VCDs, unlike PDE5Is, have not had to undergo strict clinical trials to show their safety and efficacy before their widespread usage. […] The effectiveness of VED has been established for different causes of ED. […] The use of VCD is usually well tolerated with mostly mild side effects. […] The most common side effects include numbness, pain, penile bruising or petechiae. […] VED, as PR modality, simulates natural erection and allows reoxygenation of the penis. […] Given its low complication rate and relatively high compliance rate, along with being the only modality that preserves penile length, VED is an ideal choice as PR after RP or other pelvic injuries.

• #1 Shockwave Therapy: Erectile Dysfunction (ED) Treatment | University of Utah Health | University of Utah Health

  https://healthcare.utah.edu/mens-health/conditions/erectile-dysfunction/shockwave-therapy

  Shockwave therapy is a medical treatment that has been around for many years. Recently, urologists have begun using this therapy to treat erectile dysfunction (ED). […] University of Utah Health offers shockwave therapy as an option for patients suffering from ED. Shockwave therapy is typically recommended for patients who do not respond well to medication or do not want more invasive treatments. […] Shockwave therapy for ED is still considered an experimental treatment option. There is some data to support its efficacy, but research is ongoing to determine how well it works long-term and whether it can replace or be offered along with other proven ED treatments. […] The clinical term for this treatment used by urologists is low-intensity shockwave therapy (LiSWT). During the treatment, a small wand-like device uses targeted sound waves to stimulate penile tissue and encourage blood flow, which can also speed up the healing process.

• #1 Shockwave Therapy: Erectile Dysfunction (ED) Treatment | University of Utah Health | University of Utah Health

  https://healthcare.utah.edu/mens-health/conditions/erectile-dysfunction/shockwave-therapy

  Data shows it can stimulate blood flow and potentially help grow new blood vessels. […] Since shockwave therapy is a fairly new ED treatment that is not covered by insurance plans, your urologist may recommend other ED treatment options first. […] This procedure works best for men with mild erectile dysfunction who are: not responding to medications adequately, not interested in taking medications, or interested in trying regenerative therapy to reverse some of the causes of ED. […] Clinical studies have generally shown shockwave therapy to be effective and safe, but more research is needed to identify potential risks and the best treatment protocols for someone with erectile dysfunction. […] Most people who get shockwave therapy for ED will often see benefits within one to three months. […] If you are suffering from erectile dysfunction and would like to meet with a U of U Health urologist, call 801-213-2700 to schedule an appointment.

• #1 Erectile Dysfunction (ED) | San Diego,CA

  https://www.sdsm.info/male-issues/erectile-dysfunction

  Several vacuum constriction devices (VCD) are now available commercially. […] Satisfactory use of these devices has been reported in a large number of patients. […] Simultaneous injection of intracavernous vasodilating drugs with use of a vacuum constriction device may be of help to patients who could not achieve adequate erection with either therapy alone. […] Before the introduction of intracavernous vasodilator injection therapy, testosterone injections or placement of a penile prosthesis were the only effective treatment for erectile dysfunction besides psychologic counselling. […] There are two major categories of penile prostheses; 1) the semirigid prosthesis and 2) the inflatable prosthesis.

• #1 Nonpharmacologic Treatment of Erectile Dysfunction

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1476026/

  Nonpharmacologic treatment for erectile dysfunction (ED) includes sex therapy, the use of vacuum erection devices, penile prosthesis implantation, and penile vascular surgery. […] Sex therapy by itself may resolve psychogenic ED, and because psychological factors are so often significant contributors to all types of organic ED, some form of sex therapy or counseling as an adjunct to pharmacologic and other nonpharmacologic treatment for organic ED is often helpful. […] Vacuum erection devices may have significant adverse effects and questionable acceptability, but studies show that they result in erections satisfactory for intercourse in a high percentage of users. […] Penile prostheses are available in inflatable and noninflatable forms that approximate the action of a naturally occurring erection. Three-piece inflatable penile prostheses have improved significantly in design over the last decade, and studies have reported high rates of satisfaction among users and their partners. […] Penile vascular surgery has shown reasonable success within the first year after surgery, but late failures occur. The procedure appears to be most efficacious in young men with ED resulting from pelvic or perineal trauma.

• #1 Erectile Dysfunction (ED) Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/erectile-dysfunction-(ed)-guideline

  Men with ED should be informed regarding the treatment option of penile prosthesis implantation, including discussion of benefits and risks/burdens. […] Penile prosthetic surgery should not be performed in the presence of systemic, cutaneous, or urinary tract infection. […] For young men with ED and focal pelvic/penile arterial occlusion and without documented generalized vascular disease or veno-occlusive dysfunction, penile arterial reconstruction may be considered. […] For men with ED, penile venous surgery is not recommended. […] For men with ED, low-intensity extracorporeal shock wave therapy (ESWT) should be considered investigational. […] For men with ED, intracavernosal stem cell therapy should be considered investigational. […] PRP should not be offered to men with ED unless it is administered in the context of an IRB-approved experimental clinical research protocol.

• #1 Erectile Dysfunction Treatment & Management: Approach Considerations, Pharmacologic Therapy, External Erection-Facilitating Devices

  https://emedicine.medscape.com/article/444220-treatment

  Alprostadil is the single agent most commonly used for intracavernosal injections. […] Another option for ED involves the formulation of alprostadil (PGE1) into a small intraurethral suppository that can be inserted into the urethra. […] Intraurethral alprostadil may be effective in men who have vascular disease or diabetes or have undergone prostate surgery. […] Sexual counseling is the most important part of treatment for patients with sexual problems. […] Regardless of the etiology of ED, a psychological component is frequently associated with the disorder. […] The AUA observes that because diabetes, heart disease, and hypertension increase the risk of developing ED, optimal management of these diseases may prevent the development of ED. […] A systematic review and meta-analysis by Silva et al suggested that physical activity and exercise—particularly aerobic exercise of moderate-to-vigorous intensity—improve patient-reported ED.

• #1 Erectile Dysfunction Therapy | LloydsPharmacy Online Doctor UK

  https://onlinedoctor.lloydspharmacy.com/uk/mens-health-advice/erectile-dysfunction-therapy

  Although erectile dysfunction (ED) is predominantly associated with physical causes, psychological contributions to the problem are not given enough attention. […] It is often forgotten that achieving and maintaining an erection requires a man to be psychologically engaged, rather than being a puppet of a mindless physical response. […] If the cause of your ED is psychological, using medication targeting physically-induced ED alone may not always be very effective. […] The good news is that there are a multitude of different therapies available for addressing ED. […] Cognitive behavioural therapy (CBT) is perhaps one of the most useful forms of therapy for addressing ED, especially related to performance anxiety, low self-esteem, and loss of sexual arousal. […] This type of counselling is a deeper-dive, relationship talk therapy looking at the emotional, psychological, and sexual issues which may be influencing your ED.

• #1 Erectile dysfunction | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/erectile-dysfunction-impotence/

  Surgery for erectile dysfunction is usually only recommended if all other treatment methods have failed. […] If your erectile dysfunction has an underlying psychological cause then you may benefit from a type of treatment called sensate focus. […] Cognitive behavioural therapy (CBT) is another form of counselling that may be useful if you have erectile dysfunction. […] Some studies have suggested that, in a few cases, it may be beneficial to exercise your pelvic floor muscles. […] Some complementary therapies, such as acupuncture, have claimed to treat erectile dysfunction. However, there is little evidence they are useful.

• #1 Treatment for Erectile Dysfunction – NIDDK

  https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment

  ED medicines that you take by mouth, through an injection, or as a suppository can have side effects. […] Lifestyle factors can often lead to ED or make its symptoms worse. […] If you smoke cigarettes, one of the best things you can do for your ED and your overall health is to quit smoking. […] Eating well helps to maintain erectile function. […] A healthy weight can improve testosterone levels and self-esteem, which may help prevent ED. […] Physical activity increases blood flow through your body, including the penis, and can help keep you at a healthy weight. […] Taking care of your mental and emotional health can help prevent ED. […] You can help prevent ED by avoiding recreational and illicit drugs and limiting how much alcohol you drink.

• #1 Erectile Dysfunction Treatment & Management: Approach Considerations, Pharmacologic Therapy, External Erection-Facilitating Devices

  https://emedicine.medscape.com/article/444220-treatment

  One direction of research into treatment of ED focuses on restoration of the structure and function of dysfunctional erectile tissue, rather than simply relief of symptoms. These techniques, termed regenerative therapy, include the following: Low-intensity extracorporeal shockwave therapy (LiESWT), Stem cell therapy, Intracavernous injection of platelet-rich plasma (PRP).

• #1 Erectile dysfunction | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/erectile-dysfunction-impotence/

  Erectile dysfunction is primarily treated by tackling the cause of the problem, whether this is physical or psychological. […] A number of treatments have been successful in the treatment of erectile dysfunction. Medication, such as sildenafil (sold as Viagra), can be used to manage it in at least two-thirds of cases. Vacuum pumps that encourage blood to flow to the penis and cause an erection are also successful in 90% of cases. […] Overall, treatments for erectile dysfunction have improved significantly in recent years. Most men are eventually able to have sex again. […] If your erectile dysfunction is caused by an underlying health condition, such as heart disease or diabetes, that condition may need to be treated first. In some cases, treating the underlying cause may also resolve the problem.

• #1 Erectile Dysfunction Treatment & Management: Approach Considerations, Pharmacologic Therapy, External Erection-Facilitating Devices

  https://emedicine.medscape.com/article/444220-treatment

  After all the information regarding the patients status has been gathered, the various options for management of erectile dysfunction (ED) can be discussed. It is best to include the patients partner in this discussion. One of the most difficult aspects of treatment is teaching men that sex entails more than simply achieving an erection. […] The task of the physician is to identify which treatment would be most appropriate and most likely to have long-term success. To do that, the physician must take the time to understand the patients problem and be knowledgeable about the available options. Enough options are available that every man who wants to be sexually active can be, regardless of the etiology of the problem. These include the following: […] Sexual counseling if no organic causes can be found for the dysfunction

• #1 Impotence / Erectile Dysfunction Treatment – USZ

  https://www.usz.ch/en/department/urology/service/impotence-erectile-dysfunction/

  Erectile dysfunction is a sensitive topic that people are reluctant to talk about, even though it affects more men than many people think. […] If a man consults a doctor due to erectile dysfunction, also known as impotence, there are various treatment options available depending on the underlying causes. […] When treating impotence, we proceed according to the step-by-step principle depending on the cause of the dysfunction and first try to remedy the erectile dysfunction by changing the lifestyle and providing support with medication. […] Taking so-called PDE-5 inhibitors in tablet form can help to produce an erection within a short time if you have erectile dysfunction. […] In cases of severe erectile dysfunction where other therapies have not been successful, a penile implant, also known as a penile prosthesis, can be surgically implanted. […] Psychological causes such as stress and depression can underlie impotence. Psychotherapy, which can also be designed as couples therapy, for example, can be helpful here.

• #2 Erectile dysfunction (impotence)

  https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/

  Erectile dysfunction (impotence) is very common, particularly in men over 40. It’s usually nothing to worry about, but see a GP if it keeps happening. […] Treatment can usually help improve erectile dysfunction. […] The main treatments are medicines that increase the blood flow to your penis, called PDE-5 inhibitors. […] Vacuum pumps encourage blood to flow to the penis, causing an erection. […] There are also treatments for some of the causes of erectile dysfunction. […] Counselling and therapy can help if your erection problems are linked to emotional or mental health problems but there can be a long wait for these services on the NHS.

• #2 Erectile Dysfunction (ED) Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/erectile-dysfunction-(ed)-guideline

  Clinicians should counsel men with ED who have comorbidities known to negatively affect erectile function that lifestyle modifications, including changes in diet and increased physical activity, improve overall health and may improve erectile function. […] Men with ED should be informed regarding the treatment option of an FDA-approved oral phosphodiesterase type 5 inhibitor (PDE5i), including discussion of benefits and risks/burdens, unless contraindicated. […] When men are prescribed an oral PDE5i for the treatment of ED, instructions should be provided to maximize benefit/efficacy. […] For men who are prescribed PDE5i, the dose should be titrated to provide optimal efficacy. […] Men who desire preservation of erectile function after treatment for prostate cancer by radical prostatectomy (RP) or radiotherapy (RT) should be informed that early use of PDE5i post-treatment may not improve spontaneous, unassisted erectile function.

• #2 Management of Erectile Dysfunction | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/0201/p305.html

  Erectile dysfunction (ED) is the most common sexual problem in men. […] First-line therapy for ED consists of lifestyle changes, modifying drug therapy that may cause ED, and pharmacotherapy with phosphodiesterase type 5 inhibitors. […] Phosphodiesterase type 5 inhibitors are the most effective oral drugs for treatment of ED, including ED associated with diabetes mellitus, spinal cord injury, and antidepressants. […] Testosterone supplementation in men with hypogonadism improves ED and libido, but requires interval monitoring of hemoglobin, serum transaminase, and prostate-specific antigen levels because of an increased risk of prostate adenocarcinoma. […] Cognitive behavior therapy and therapy aimed at improving relationships may help to improve ED. […] First-line therapy for erectile dysfunction should consist of oral phosphodiesterase type 5 inhibitors.

• #2 Erectile Dysfunction (Impotence)

  https://www.webmd.com/erectile-dysfunction/understanding-erectile-dysfunction-basics

  Erectile dysfunction (ED), also known as impotence, happens when you can’t get or keep an erection of the penis that’s adequate for the sexual satisfaction of both partners. […] Nearly all those who seek treatment for ED find some relief. […] The treatment for your ED will depend on what’s causing it, as well as what you and your partner think will work best. Your doctor can help you decide. Treatments include: […] Medications. You take drugs such as sildenafil (Viagra), vardenafil (Levitra, Staxyn), and tadalafil (Cialis, Adcirca) as pills before you have sex. They work by increasing blood flow to your penis. This helps you get an erection once you’re sexually excited. […] Lifestyle changes. Your doctor might suggest that you lose weight or start an exercise routine to improve your ED symptoms. They might also recommend that you stop smoking, drinking alcohol, or using marijuana or other drugs. […] Counseling. If stress, depression, or relationship problems contribute to your ED, talking to a counselor could help. […] Vacuum device. Also called a penis pump, this is a tube that fits over your penis. It includes a pump, which you use to suck air from the tube. This pulls blood into your penis to make it erect. You place an elastic ring around the bottom of your penis to keep it erect and take off the vacuum tube. After sex, you remove the ring to end the erection. […] Surgery. Most men don’t get surgery for ED. But in some cases, doctors will do an operation to repair your arteries to boost blood flow to your penis. Or they can implant a bendable or inflatable rod inside your penis that you adjust to make it erect.

• #2 Erectile Dysfunction Treatment & Management: Approach Considerations, Pharmacologic Therapy, External Erection-Facilitating Devices

  https://emedicine.medscape.com/article/444220-treatment

  The Princeton Consensus Panel has produced guidelines for managing ED in patients with cardiovascular disease. […] The panel advises that a man with ED and no cardiac symptoms should be considered to have cardiac or vascular disease until proven otherwise. ED patients should be assessed and categorized as high-, intermediate-, or low-risk. This stratification can guide management. […] Risk-factor modification, including lifestyle interventions (eg, exercise and weight loss) is strongly encouraged for ED patients with cardiovascular disease. […] Patients who have serious cardiac disease or exertional angina or are taking multiple antihypertensive medications should seek the advice of a cardiologist before beginning therapy with a PDE5 inhibitor. […] Nevertheless, several studies examining the cardiac effects of sildenafil and tadalafil have found no increased risk of cardiovascular events in comparison with placebo.

• #2 Erectile Dysfunction (ED) Treatment: Medication & Surgery

  https://www.health.com/erectile-dysfunction-treatment-8735830

  Erectile dysfunction (ED) is an inability to achieve or maintain an erection during sex or with sexual stimulation. It can affect people at any age but becomes more common as you age. […] Though individual results vary, ED is generally treatable. […] ED is treated by primary care physicians, urologists (urinary system specialists), and/or therapists. […] Prescribed medications are often the first line of treatment for erectile dysfunction. They work to promote blood flow to the penis, which can address symptoms of ED, including maintaining an erection. […] Testosterone replacement therapy may be recommended. This treatment can be given through injections, pills, topical gels, or implants. […] When PDE-5 inhibitors do not work, injections are another option. […] A variety of surgeries and other approaches may be used to treat severe and more difficult-to-manage cases of erectile dysfunction.

• #2 Erectile Dysfunction: Erection Problems, Treatment, Surgery, and Complications

  https://www.webmd.com/erectile-dysfunction/erectile-dysfunction-treatment

  If you think you have erectile dysfunction, or ED, a good first step is to talk with your doctor. The treatment you need will depend on whats causing it. […] Erectile dysfunction can be caused by mental or physical issues. Be honest with your doctor about your medical and sexual history to help them find a treatment that’s right for you. […] Your doctor may tell you to make some day-to-day adjustments. Expect to hear things like: Stop any tobacco or illegal drug use. Cut back on alcohol. Lower stress. Eat a healthy diet. Exercise regularly. Lose weight if you’re overweight or obese. Lower your cholesterol and blood pressure levels. […] If anxiety or stress is causing your ED, it may help to talk to a professional therapist. […] ED medicines can be pills, drugs inserted into the tip of the penis, or shots into the penis.

• #2 Erectile Dysfunction: Erection Problems, Treatment, Surgery, and Complications

  https://www.webmd.com/erectile-dysfunction/erectile-dysfunction-treatment

  If the pills dont work or arent safe for you to take, your doctor may prescribe a drug called alprostadil. It helps boost blood flow to the penis, triggering an erection within minutes. […] A vacuum device improves firmness by boosting blood flow to the penis. About 80% of people who use the device correctly get an erection hard enough for sex. […] If all other ED treatments have failed, your doctor may recommend surgery. […] There are other treatments you can explore: Acupuncture. This traditional Chinese practice involves placing very fine needles at certain spots on your body. […] Some insurance policies cover ED treatment if its medically necessary. Check with your insurance provider.

• #2 Reddit – The heart of the internet

  https://www.reddit.com/r/erectiledysfunction/comments/1gt27vd/master_list_of_erectile_dysfunction_therapies/

  Vacuum erectile device cock ring […] PRP Shot or Stem Cell shot […] Vertica (First generation RF wave therapy devices) […] E-STIM device for low intensity electric shock (Low Risk With due diligence) […] Botox Injection (Unknown risk factors) […] Vascular surgeries (NOT RECOMMENDED) (VERY Risky) […] Prosthetic (NOT RECOMMENDED) (VERY Risky) […] Red-light therapy (UNKNOWN EFFICACY BUT LOW RISK) […] Gene therapy (FUTURE THERAPY) […] Nano-Technology (FUTURE THERAPY) […] Prescriptions (never combine or mix without doctor supervision) […] Viagra, Stendra (possibly fewer side effects), Cialis, and Vardenafil. […] PGE-1 (topical, sub-urethral, or injection) […] TriMix or BiMix Injections (Risky) […] PT-141 (Psychological) […] Any supplement clinically shown to alter or affect your hormones may also have an effect on libido and erectile dysfunction.

• #2 Erectile Dysfunction (ED): Symptoms, Causes, and Treatment

  https://patient.info/mens-health/erectile-dysfunction-impotence

  This was the most common treatment before ED tablets became available. It usually works very well. You are taught how to inject a medicine into the base of the penis. This causes increased blood flow, following which an erection usually develops within 15 minutes. […] You can place a small pellet into the end of the tube which passes urine and opens at the end of the penis (the urethra). The pellet contains a similar medicine to that used for the injection treatment. The medicine is quickly absorbed into the penis to cause an erection, usually within 10-15 minutes. […] There are several different devices. Basically, you put your penis into a plastic container. A vacuum pump then sucks out the air from the container to create a vacuum. This pulls blood flow to your penis and cause an erection.

• #2 Shockwave Therapy for Erectile Dysfunction

  https://www.healthline.com/health/shockwave-therapy-for-ed

  Though not yet an FDA approved treatment for erectile dysfunction, studies show improved erectile function following shockwave therapy. […] Shockwave therapy is one of the many treatment options for erectile dysfunction (ED). […] Shockwave therapy appears to work best for those with vasculogenic ED, which is a blood vessel disorder that affects blood flow to the tissue in the penis. […] Erections rely on healthy blood flow to the penile tissue. Shockwave therapy is viewed favorably as a way of repairing and strengthening blood vessels in the penis and improving blood flow. […] The same 2019 review and meta-analysis found that erectile function significantly improved with shockwave therapy. Results were best among men with vasculogenic ED. […] Despite this encouraging research, the Food and Drug Administration (FDA) hasnt approved shockwave therapy as a treatment for ED.

• #2 Shockwave Therapy: Erectile Dysfunction (ED) Treatment | University of Utah Health | University of Utah Health

  https://healthcare.utah.edu/mens-health/conditions/erectile-dysfunction/shockwave-therapy

  Data shows it can stimulate blood flow and potentially help grow new blood vessels. […] Since shockwave therapy is a fairly new ED treatment that is not covered by insurance plans, your urologist may recommend other ED treatment options first. […] This procedure works best for men with mild erectile dysfunction who are: not responding to medications adequately, not interested in taking medications, or interested in trying regenerative therapy to reverse some of the causes of ED. […] Clinical studies have generally shown shockwave therapy to be effective and safe, but more research is needed to identify potential risks and the best treatment protocols for someone with erectile dysfunction. […] Most people who get shockwave therapy for ED will often see benefits within one to three months. […] If you are suffering from erectile dysfunction and would like to meet with a U of U Health urologist, call 801-213-2700 to schedule an appointment.

• #2 Erectile dysfunction: Nonoral treatments

  https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/in-depth/nonoral-erectile-dysfunction-treatments/art-20045578

  Testosterone replacement. Some people have erectile dysfunction due to low levels of the hormone testosterone. In this case, you might benefit from testosterone replacement therapy. […] A penis pump is used to draw blood into the penis to create an erection. […] If medications don’t work or aren’t right for you, a different type of treatment might help. Other treatments include: […] Penile implants. This treatment involves surgery to place devices into both sides of the penis. […] Sometimes, erectile dysfunction is caused by stress, anxiety or depression. […] It’s key to get treatment for any medical issue that causes erectile dysfunction. […] If you have erectile dysfunction, you’re not alone and you have many treatment choices. Work with your health care team to find out which ED treatment might work best for you.

• #2 Erectile Dysfunction Treatment – William Brant, MD

  https://www.menssexualhealthutah.com/mens-health/erectile-dysfunction-treatment/

  Penile implants: A device is implanted into the penis that is intended to allow a man with ED to have an erection. The device is entirely contained in the body so no one is able to see it and is controlled by the user to achieve an erection. This treatment is designed to allow for spontaneity and the erection is maintained for as long as the man desires. […] If you’re not having success with conservative erectile dysfunction treatments, the team may recommend a penile implant procedure. This device is a long-lasting solution to help you achieve firmer erections in a more natural manner; Dr. Brant performs more penile implant procedures than anyone in the area. […] A one-piece penile implant involves placing semirigid cylinders into the erection bodies of your penis. This implant helps you have a penis that’s rigid enough for sexual intercourse but soft (flaccid) enough to conceal under your clothes. A one-piece penile implant is the least expensive solution and works quickly, but it does result in the least natural erection (compared to other devices).

• #2 Erectile Disfunction Treatment | Archbold Memorial

  https://www.archbold.org/services/urology-services/erectile-dysfunction-treatment/

  Erectile dysfunction (ED) is defined as the inability to achieve or maintain a penile erection sufficient for satisfactory sexual performance. […] Whatever is causing your ED, there is a treatment option that can provide a satisfying solution. Oral medications are a common first step, but they dont work for everyone or may stop working. Other treatments include vacuum erection devices, injections and intraurethral suppositories. A penile implant is designed to be a permanent solution for men suffering from ED and can provide an erection whenever and wherever desired. […] With a penile implant, the possibility of organic erections or alternative treatment options for ED are eliminated. Possible risks of a penile implant include: mechanical failure of the device, which may require revision surgery; and upon removal or replacement of the implant, the penis may become scarred, shorter or curved. Pain associated with the healing process can be expected. With the procedure, there is a risk of infection (1-2.5% risk with the AMS penile implant10) and men with diabetes, spinal cord injuries or open sores may have an increased risk of infection. Talk to your doctor for a complete list of risks, warnings and safety information.

• #2 Erectile Dysfunction (ED) Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/erectile-dysfunction-(ed)-guideline

  Men with ED should be informed regarding the treatment option of penile prosthesis implantation, including discussion of benefits and risks/burdens. […] Penile prosthetic surgery should not be performed in the presence of systemic, cutaneous, or urinary tract infection. […] For young men with ED and focal pelvic/penile arterial occlusion and without documented generalized vascular disease or veno-occlusive dysfunction, penile arterial reconstruction may be considered. […] For men with ED, penile venous surgery is not recommended. […] For men with ED, low-intensity extracorporeal shock wave therapy (ESWT) should be considered investigational. […] For men with ED, intracavernosal stem cell therapy should be considered investigational. […] PRP should not be offered to men with ED unless it is administered in the context of an IRB-approved experimental clinical research protocol.

• #2 Erectile Dysfunction Therapy | LloydsPharmacy Online Doctor UK

  https://onlinedoctor.lloydspharmacy.com/uk/mens-health-advice/erectile-dysfunction-therapy

  Although erectile dysfunction (ED) is predominantly associated with physical causes, psychological contributions to the problem are not given enough attention. […] It is often forgotten that achieving and maintaining an erection requires a man to be psychologically engaged, rather than being a puppet of a mindless physical response. […] If the cause of your ED is psychological, using medication targeting physically-induced ED alone may not always be very effective. […] The good news is that there are a multitude of different therapies available for addressing ED. […] Cognitive behavioural therapy (CBT) is perhaps one of the most useful forms of therapy for addressing ED, especially related to performance anxiety, low self-esteem, and loss of sexual arousal. […] This type of counselling is a deeper-dive, relationship talk therapy looking at the emotional, psychological, and sexual issues which may be influencing your ED.

• #2 Nonpharmacologic Treatment of Erectile Dysfunction

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1476026/

  Nonpharmacologic treatment for erectile dysfunction (ED) includes sex therapy, the use of vacuum erection devices, penile prosthesis implantation, and penile vascular surgery. […] Sex therapy by itself may resolve psychogenic ED, and because psychological factors are so often significant contributors to all types of organic ED, some form of sex therapy or counseling as an adjunct to pharmacologic and other nonpharmacologic treatment for organic ED is often helpful. […] Vacuum erection devices may have significant adverse effects and questionable acceptability, but studies show that they result in erections satisfactory for intercourse in a high percentage of users. […] Penile prostheses are available in inflatable and noninflatable forms that approximate the action of a naturally occurring erection. Three-piece inflatable penile prostheses have improved significantly in design over the last decade, and studies have reported high rates of satisfaction among users and their partners. […] Penile vascular surgery has shown reasonable success within the first year after surgery, but late failures occur. The procedure appears to be most efficacious in young men with ED resulting from pelvic or perineal trauma.

• #2 Erectile dysfunction | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/erectile-dysfunction-impotence/

  Surgery for erectile dysfunction is usually only recommended if all other treatment methods have failed. […] If your erectile dysfunction has an underlying psychological cause then you may benefit from a type of treatment called sensate focus. […] Cognitive behavioural therapy (CBT) is another form of counselling that may be useful if you have erectile dysfunction. […] Some studies have suggested that, in a few cases, it may be beneficial to exercise your pelvic floor muscles. […] Some complementary therapies, such as acupuncture, have claimed to treat erectile dysfunction. However, there is little evidence they are useful.

• #2 Erectile Dysfunction Therapy | LloydsPharmacy Online Doctor UK

  https://onlinedoctor.lloydspharmacy.com/uk/mens-health-advice/erectile-dysfunction-therapy

  This form of therapy has a shorter-term focus and centres on the experience of sex itself. […] Any man suffering from ED, regardless of whether psychologically or physically rooted, is strongly encouraged to be assessed by their GP. […] If the cause of your ED is deemed to be psychological, your GP may refer you to a sex therapist if they think it will help. […] Aside from therapy, there are lots of other treatments available for ED.

• #2 Erectile Dysfunction (ED) | San Diego,CA

  https://www.sdsm.info/male-issues/erectile-dysfunction

  Erectile dysfunction affects men of all ages; but its incidence increases with age. […] After appropriate history, physical and diagnostic evaluation has established the probable diagnosis of psychogenic erectile dysfunction, an attempt at psychosexual therapy is indicated. […] There are few controlled studies establishing the effectiveness of behavior therapy for functional erectile dysfunction. […] In 2010, low-intensity shockwave therapy (Li-SWT) was first used in Europe as a novel, minimally-invasive disease modification treatment strategy for ED. […] The European Urological Association has listed Li-SWT as a treatment for ED. […] Platelet rich plasma therapy for erectile dysfunction is an experimental therapy that delivers your own body’s plasma to the erection tissue, hypothesized to encourage the release of important growth factors into the penile tissues that decrease inflammation, increase blood flow and increase penile smooth muscle cell function.

• #2 Erectile Dysfunction (ED) Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/erectile-dysfunction-(ed)-guideline

  The Panel reviewed the evidence on all therapies for ED. Treatments judged to be effective and that appear to be generally safe (e.g., PDE5i, VED, ICI) are reviewed above, and guidance is provided in the form of statements. Selected treatments that are available but that in the Panel’s judgement are ineffective and involve substantial risks/burdens (e.g., venous ligation surgery, PRP, ESWT) and, based on current evidence, should not be offered also are addressed.

• #2 Erectile Dysfunction Treatment & Management: Approach Considerations, Pharmacologic Therapy, External Erection-Facilitating Devices

  https://emedicine.medscape.com/article/444220-treatment

  Alprostadil is the single agent most commonly used for intracavernosal injections. […] Another option for ED involves the formulation of alprostadil (PGE1) into a small intraurethral suppository that can be inserted into the urethra. […] Intraurethral alprostadil may be effective in men who have vascular disease or diabetes or have undergone prostate surgery. […] Sexual counseling is the most important part of treatment for patients with sexual problems. […] Regardless of the etiology of ED, a psychological component is frequently associated with the disorder. […] The AUA observes that because diabetes, heart disease, and hypertension increase the risk of developing ED, optimal management of these diseases may prevent the development of ED. […] A systematic review and meta-analysis by Silva et al suggested that physical activity and exercise—particularly aerobic exercise of moderate-to-vigorous intensity—improve patient-reported ED.

• #2 Erectile Dysfunction (ED) Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/erectile-dysfunction-(ed)-guideline

  Erectile Dysfunction: AUA Guideline (2018) […] The purpose of this guideline is to provide a clinical strategy for the diagnosis and treatment of erectile dysfunction (ED). […] The purpose of this guideline is to provide a clinical strategy for the diagnosis and treatment of erectile dysfunction (ED). Using the shared decision-making process as a cornerstone for care, all patients should be informed of all treatment modalities that are not contraindicated, regardless of invasiveness or irreversibility, as potential first-line treatments. For each treatment, the clinician should ensure that the man and his partner have a full understanding of the benefits and risk/burdens associated with that choice. […] For men being treated for ED, referral to a mental health professional should be considered to promote treatment adherence, reduce performance anxiety, and integrate treatments into a sexual relationship.

• #2 Erectile Dysfunction > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/erectile-dysfunction

  Minimally invasive penile implant surgery: which our experienced physicians routinely perform. Most patients recover full sexual function in six to eight weeks. […] Almost all cases of erectile dysfunction are treatable, and treatment can lead to better overall physical and emotional health for nearly every patient as well as improve intimacy for couples. […] Dr. Honig is an internationally recognized speaker on issues related to sexual health and conducts research into experimental treatments of erectile dysfunction.

• #3 Erectile dysfunction – Wikipedia

  https://en.wikipedia.org/wiki/Erectile_dysfunction

  The PDE5 inhibitors sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) are prescription drugs which are taken by mouth. […] Focused shockwave therapy involves passing short, high frequency acoustic pulses through the skin and into the penis. These waves break down any plaques within the blood vessels, encourage the formation of new vessels, and stimulate repair and tissue regeneration. […] Men with low levels of testosterone can experience ED. Taking testosterone may help maintain an erection. […] A vacuum erection device helps draw blood into the penis by applying negative pressure. […] The vibrator was invented in the late 19th century as a medical instrument for pain relief and the treatment of various ailments. […] Often, as a last resort, if other treatments have failed, the most common procedure is prosthetic implants which involves the insertion of artificial rods into the penis. […] The Food and Drug Administration (FDA) does not recommend alternative therapies to treat sexual dysfunction.

• #3 Treatment Options for Erectile Dysfunction – North Alabama Urology, PC

  https://www.northalaurology.com/mens-health/treatment-options-for-erectile-dysfunction/

  Pills like Viagra™, Cialis™, Levitra™, or Stendra™ may help achieve erections in response to stimulation. They generally should be taken at least half an hour to one hour before anticipated sexual activity. Potential side effects include headaches, facial blushing, upset stomach, back pain/muscle aches, and nasal congestion. […] A penile injection is placed into the penis to inject medication to create an erection. This produces an erection within 5-20 minutes. Potential side effects include priapism (erection lasting 4 hours or more), penile pain, numbness or irritation, bruising at the injection site, and penile fibrosis (deformed penis shape). […] Vacuum erection devices are external pumps placed over the penis to help with ED. The device, consisting of a cylinder and pump, creates a vacuum that pulls blood into the penis creating an erection and a constriction ring that helps maintain the erection. Patients who use vacuum erection devices may experience penile discomfort, penile numbness, and an erection that is not warm to the touch, among other potential side effects.

• #3 Erectile dysfunction: Nonoral treatments

  https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/in-depth/nonoral-erectile-dysfunction-treatments/art-20045578

  Testosterone replacement. Some people have erectile dysfunction due to low levels of the hormone testosterone. In this case, you might benefit from testosterone replacement therapy. […] A penis pump is used to draw blood into the penis to create an erection. […] If medications don’t work or aren’t right for you, a different type of treatment might help. Other treatments include: […] Penile implants. This treatment involves surgery to place devices into both sides of the penis. […] Sometimes, erectile dysfunction is caused by stress, anxiety or depression. […] It’s key to get treatment for any medical issue that causes erectile dysfunction. […] If you have erectile dysfunction, you’re not alone and you have many treatment choices. Work with your health care team to find out which ED treatment might work best for you.

• #3 Erectile Dysfunction Treatment – William Brant, MD

  https://www.menssexualhealthutah.com/mens-health/erectile-dysfunction-treatment/

  A two-piece penile implant involves concealing a pump in your scrotum (almost like a third small testicle) and filling cylinders with fluid. You use the pump to achieve an erection and then bend your penis in a certain position to help drain the fluid. A two-piece penile implant results in excellent rigidity, although because it results in poor flaccidity, it’s not an ideal solution for very thin men or men with larger penises. […] As the most commonly used penile implant, three-piece implants are highly effective. This implant involves placing a pump into your scrotum (just like a two-piece implant), but this pump both inflates and deflates the cylinders. The system has a reservoir that goes into your pelvis or abdomen and holds fluid when your penis is flaccid. […] A three-piece penile implant results in excellent rigidity and flaccidity and total control over your erection. Typically, the team recommends a three-piece implant in all cases unless you have an issue in which it wouldn’t be safe or effective for you.

• #3 Erectile Dysfunction (ED) Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/erectile-dysfunction-(ed)-guideline

  Clinicians should counsel men with ED who have comorbidities known to negatively affect erectile function that lifestyle modifications, including changes in diet and increased physical activity, improve overall health and may improve erectile function. […] Men with ED should be informed regarding the treatment option of an FDA-approved oral phosphodiesterase type 5 inhibitor (PDE5i), including discussion of benefits and risks/burdens, unless contraindicated. […] When men are prescribed an oral PDE5i for the treatment of ED, instructions should be provided to maximize benefit/efficacy. […] For men who are prescribed PDE5i, the dose should be titrated to provide optimal efficacy. […] Men who desire preservation of erectile function after treatment for prostate cancer by radical prostatectomy (RP) or radiotherapy (RT) should be informed that early use of PDE5i post-treatment may not improve spontaneous, unassisted erectile function.

• #3 Get Erectile Dysfunction Treatment | Cleveland Clinic

  https://my.clevelandclinic.org/services/erectile-dysfunction-treatment

  Had a stressful day? Didnt get enough sleep? Had a few too many beers while unwinding? All of these things can cause erectile dysfunction. […] If youre having ED more than half of the time and youre not sure why, it could be a medical issue one thats common and treatable. […] Our urologists meet the highest standards and stay up to date on the latest ED treatments. […] We know it isnt necessarily easy to talk about erectile dysfunction. […] If other medical treatments are causing your erectile dysfunction, well work alongside other Cleveland Clinic specialists to find alternatives. […] We perform a high volume of penile implant surgeries. […] Solving ED starts with a conversation about whats causing your symptoms and which therapies can help. Treatments may include: […] Lifestyle changes, like quitting smoking, exercising more and lowering stress, may make your symptoms less severe.

• #3 Erectile Dysfunction (Impotence)

  https://www.webmd.com/erectile-dysfunction/understanding-erectile-dysfunction-basics

  Erectile dysfunction is a common condition. If you have ED, you are not alone. There are many treatments available for ED. Talk to your doctor about what option might work for you. […] A power outage below the belt is another good reason to eat nutritious foods, maintain a healthy weight, get some exercise, dont abuse alcohol, and stay away from tobacco. ED can strain relationships. Teaming up with your partner to find a solution is the best strategy.

• #4 Erectile Dysfunction Treatment & Management: Approach Considerations, Pharmacologic Therapy, External Erection-Facilitating Devices

  https://emedicine.medscape.com/article/444220-treatment

  Alprostadil is the single agent most commonly used for intracavernosal injections. […] Another option for ED involves the formulation of alprostadil (PGE1) into a small intraurethral suppository that can be inserted into the urethra. […] Intraurethral alprostadil may be effective in men who have vascular disease or diabetes or have undergone prostate surgery. […] Sexual counseling is the most important part of treatment for patients with sexual problems. […] Regardless of the etiology of ED, a psychological component is frequently associated with the disorder. […] The AUA observes that because diabetes, heart disease, and hypertension increase the risk of developing ED, optimal management of these diseases may prevent the development of ED. […] A systematic review and meta-analysis by Silva et al suggested that physical activity and exercise—particularly aerobic exercise of moderate-to-vigorous intensity—improve patient-reported ED.

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