Half of men over the age of 40 will have some problems with erectile dysfunction (ED), and the prevalence increases with age. The good news is that there are many treatment options available from our office in Bend.
There are many causes of ED. The men most at risk include smokers, men with diabetes, heart disease or high blood pressure. Often erectile dysfunction is an initial sign of more serious problems, so it is imperative that you see your doctor. Heart disease and other issues may need to be ruled out. The evaluation for ED is easy, and you have already started the hardest part, which is talking to a doctor about your problem. If you are looking at this website, you have probably spent months or years with the disease, and something has finally motivated you to see what can be done.
When you come to Urology Specialists of Oregon you should understand a couple of things. First, this is what we do all day long, and nothing will surprise us. Second, we can help you. In other words, we can get you an erection, it just depends on what treatments you wish to pursue to get there. The evaluation will be a detailed history and physical exam to evaluate for things like heart and blood vessel disease, and a blood test to evaluate you for low testosterone. After that, the conversation turns to action. How can we fix this?
No matter how you get to our office, whether you are diabetic, have a spinal cord injury, or have history of prostate cancer, there are 4 choices for E.D. treatment. Initially, pills such as Viagra are offered. Most men that come in have already tried these medications at least once. And for some, they work well. If however, you have tried them 4 or more times, and there has been little effect, or an unreliable result, you may want to consider other options. Some men cannot tolerate these medications due to side effects or interactions with other medications.
Another choice is a vacuum erectile device (VED). A VED is an external device that can bring blood flow into the penis, and create an erection. It works well, but takes practice. The advantages are that it is cost effective and that there are no side effects. The problem is that it can be cumbersome and not very spontaneous. In our experience, very few men find this to be a reliable solution.
Injections of medications (Trimix/Alprostadil) can help men that have all types of ED. Often times when presented with the idea of injecting a needle into the base of the penis, patients start to shake their heads in disbelief. “You want me to inject a needle WHERE?.” However, for the motivated couple this can be a very straightforward solution. The medication works by opening up blood vessels that promote an erection. If you decide to try injections, you will receive a test injection in the office. You are encouraged to bring your partner for this visit so that you can both hear the instructions. If you decide that you would like to try the injections, then a prescription is given, and you are sent home to try it on your own. The most important thing to understand, is that most couples will require at least 6 -10 tries before they find the correct dose and correct technique. In other words, expect some trial and error in the early going. The good news is that pills like Viagra can cost $30 or more per pill, injections usually cost $2-3 per dose.
For the patient that is unable to have success with injections, pills or vacuum pumps, a penile implant can be considered. An implant is a device that is placed during a 40 minute procedure under a general anesthetic, and will allow you to have erections at any time. The advantages are spontaneity, and an erection that is totally reliable. The disadvantages are that you have to go through a procedure and a period of 6 weeks of healing before you can use the device. The satisfaction rates for penile implant surgery is very high, but it is only a decision that can be made after a detailed discussion with your urologist and your partner.
If you would like a copy of the book “Ending ED and Incontinence”, please contact our office and one will be mailed to you. You can also schedule an appointment with Urology Specialists of Oregon for erectile dysfunction treatment at (541) 322-5753 or schedule an appointment online below.