Erectile Dysfunction TREATMENT
Considered a very effective but often under-utilized treatment for Erectile Dysfunction, ICP involves an injection of a combination of FDA-approved vasodilators into the spongy tissue of the penis, using an auto-applicator. This combination causes an expansion of the penile arteries and penile tissues, resulting in increased blood flow to the penis. An erection typically develops within minutes. The erection feels perfectly natural and normal; however, it will not subside after ejaculation until the effect of the medicine wears off. In rare cases side-effects of ICP include penile bruising, pain or tenderness, scarring, and a prolonged erection (known as a priapism).Boston Medical Group physicians have developed a unique approach to this method that has been effective for thousands of patients. Because it is applied locally and is non-systemic, it is often recommended for men with diabetes, heart conditions, high blood pressure or other illnesses. In the last 15 years ICP has re-emerged as a treatment option for men who do not respond to well-known oral medications for ED. Many men prefer to use ICP over other methods given its record of safety, quality, and highly predicable results.
Oral medications for ED have become very well known, and their convenience often makes them the first-line of treatment. While effective for many men, those who take nitrates for chest pain should not use oral medications given the potential for an unsafe drop in blood pressure. Other potential side effects include, but are not limited to, blurred vision, loss of hearing, and headaches.
MUSE contains a vasodilator known as Alprostadil (or Prostaglandine E1) prepared in the form of a pellet that is inserted into the urethra, via an applicator. The medicine is absorbed through the urethral wall into the erectile chambers known as the corpus cavernosa.
Given the availability of less invasive, more effective treatments, penile prosthesis is often a treatment of last resort. The best penile prosthesis is comprised of two inflatable tubes, a pump, and a reservoir. The tubes are surgically inserted into the corpus cavernosa, the pump in the scrotum and the reservoir behind the pubic bones. When the pump is activated, fluid flows from the reservoir into the tubes, which harden and become erect. Pressing a valve on the pump mechanism deactivates it, and the fluid returns to the reservoir, resulting in a flaccid penis. Complications can include infection, bleeding, pain and discomfort, mechanical failure, or extrusion of part of the prosthesis through a weakened wall of the erectile chambers.
Penile implant surgery is a major surgery that is usually invasive and expensive. Nonetheless, it can benefit men who do not respond to any other form of treatment.
These surgical procedures are not performed by Boston Medical Group physicians.
A VSD is a battery or manually-operated cylindrical pump which fully encloses the penis. When activated, it creates a vacuum by sucking air out of the sealed chamber, which draws blood to the penis. A firm rubber ring is placed around the base of the penis to trap the blood in the erectile chamber, which keeps the penis firm. Disadvantages can include incomplete erections, discomfort, and the time required for operation, but VSDs are often valuable when used along with other treatments, like ICP.
Approximately 2% to 5% of patients are candidates for vascular reconstructive surgery, which includes arterial bypass and venous ligation. Risks include those related to other major surgical procedures. Boston Medical Group physicians do not perform these surgeries.
Some men experience a condition called andropause, similar to menopause in women, which can be caused by low testosterone. Symptoms can include, but are not limited to, feelings of sluggishness, fatigue, poor sleeping habits, weight gain, low sex drive, or erectile dysfunction. For the appropriate candidate, hormonal replacement therapy can be valuable in reversing these symptoms and even improve libido (sexual drive).
Blood tests are required for the purpose of diagnosis, monitoring the treatment effectiveness, as well as any other adverse side-effects.
Sex therapy is often the treatment of choice for patients with psychological Erectile Dysfunction. It demands the cooperation of the sexual partner, multiple sessions, and an experienced sex therapist for the best results.
For men who can otherwise tolerate the side-effects of Oral Medications but want a more potent and faster acting solution. These tablets have the same contraindications and side effects as standard Oral Medications but due to faster absorption the have a faster onset of response.