Erectile Dysfunction (ED)

Erectile dysfunction (ED), is the most common sex-related issue men report to their physicians. More than 50% of men over the age of 40 may experience some issues with erections.

Erectile dysfunction can impact your sexual health but also your psychological health, relationships, self esteem and overall quality of life. At EvergreenHealth Urology & Urogynecology care, our team of specialists will partner with you to develop a personalized care pathway from evaluation to treatment options.

Causes of Erectile Dysfunction (ED)

For many men there are a variety of things which may impact your erections. For most men, the main cause is not enough blood pumping through the arteries in the penis. These issues may be caused by high blood pressure, high cholesterol affecting your arteries, and/or heart disease.

Another cause of ED is from prostate cancer treatments. Surgery, including robotic radical prostatectomy, or radiation, can impact the nerves leading to the penis. For some men, they will recover their erectile function over time, though some are impacted long-term.

The good news is erectile dysfunction is treatable – we can help. At EvergreenHealth Urology & Urogynecology care, we offer all of the FDA-approved treatment options for erectile dysfunction.

These include:

Oral Medications 
Tadalafil (Cialis), Sildenafil (Viagra, Revatio), Vardenafil (Levitra) and Avanafil (Stendra) are all oral medication options for treating erectile dysfunction. These medications work best taken on an empty stomach about 30-60 minutes before sexual activity. Tadalafil (Cialis) also has a daily option.

These medications belong to a class of medications called PDE-5 inhibitors which cause relaxation of the smooth muscle in the penis to cause an erection.

Possible side effects include headache, flushing of the face, nasal congestion, nausea, back pain, changes in vision and prolonged erections (need medical attention if >4 hours)

Penile Injections
When oral medications no longer work, direct penile injections are an option. The first injection is performed in the office to ensure the proper medication dosage and for your physician to teach you how to do the injections. While many men are hesitant about injections, after trialing the medication their feedback is positive.

Possible side effects include bruising, swelling, pain, prolonged erection (need medical attention if >4 hours)

Penile implant
An inflatable penile implant (IPP) is a common treatment option for men with ED. Men regain the ability to get a durable, reliable erection that they are in control of. Typically, in 30-60 seconds they can get a rigid erection that can last as long as they want it to.
The inflatable penile implant is the most common type of penile implant and allows for better rigidity and the ability to deflate and inflate the implant. The other option is a malleable penile implant. The surgery to place a penile implant is made through the scrotum where two cylinders are placed in the penis connected under the skin to a pump between the two testicles and also connected to a reservoir. This is a self-enclosed system filled with saline and never needs to be refilled – fluid flows from one part of the system to another with the use of the pump. The reservoir is placed behind the pubic bone.

Each implant is custom fitted to you and has incredibly high patient and partner satisfaction rates (>95%). Over 80% of implants last 10 years or more.

Risks include bruising, swelling, infection (<1%), mechanical failure, damage to surrounding structures