The last decades have seen a significant improvement in the management of erectile dysfunction, as a variety of medical and surgical solutions are now available to improve the quality of erections.
Erectile dysfunction remains a very complex issue and patients require an expert evaluation to determine the underlying causes of the problem and to identify the most appropriate treatment. Frequently erectile dysfunction is a sign of cardiovascular disease or of hormonal imbalances and therefore the patient needs to be thoroughly investigated.
We offer a wide range of investigations, which will be tailored to each patient’s need. All men should have a detailed consultation and clinical examination at which time a full history will be taken. In patients who do not respond to Viagra, Cialis and Levitra, a test injection might be given to see if this produces an adequate erection. If the patient responds well to injections, then injections can be offered as a definitive form of therapy.
At present, patients can be offered a wide range of treatments depending on the cause of the erectile dysfunction. These range from oral medications (Viagra, Cialis, Levitra) to injections into the corpora of the penis (Caverject). Vacuum devices are a valid alternative to drug therapies in selected patients and may be useful when drugs do not work.
Some rare abnormalities of the penile vasculature can be successfully corrected with revascularization surgery. It is essential therefore for such patients to be assessed by the radiologist and surgeon in order to determine whether they are likely to benefit from this type of surgery.
If none of the medical treatments is successful then patients are offered implantation of a penile prosthesis, which guarantees the rigidity necessary for penetrative sexual intercourse. A variety of penile prostheses are currently available on the market. The simplest are the semi-rigid or malleable prostheses but many men prefer the hydraulic devices, as they can be deflated when the erection is not required and guarantee a better rigidity.