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What treatment is available?
Ultimately it is your decision as to what treatment you choose; you will, of course, be given guidance as to what is most appropriate for you.
Counselling
Some men do need counselling and they will be referred to a specialist in this area. Counselling can be part or all of the treatment required.
Tablet treatment
First line treatment for most patients is now tablet treatment using either avanafil, sildenafil, tadalafil, or vardenafil. Our specialists will prescribe this for you in the first instance.
Hormone treatment
This is offered to those patients who are deficient in male hormones i.e. testosterone. Medication can restore the hormone imbalance and improve potency. This treatment will not have any effect on those who do not have a hormone imbalance.
Self-injection therapy
This treatment involves self-injecting a drug into the side of the penis each time you want to have an erection. The injection causes the muscle in the penis to relax allowing increased blood flow into the area.
Injection therapy is very effective for many men but some do find the very thought of self-injection unacceptable. If you decide to choose this option then you will be trained in the clinic how to inject yourself.
Injection therapy can be used a maximum of twice a week and never more than once in 24 hours. As with all drugs there are side effects. Occasionally the erection does not go down and you may need to come to hospital to have the erection reduced. This is not common.
MUSE (medicated urethral system for erection)
This involves insertion of a pellet of prostaglandin into the urethra (water passage). Erections occur in only 35 to 40% of patients and treatment can be associated with pain or facial flushing.
Vacuum erection assistance devices
These are a non-invasive method of getting and sustaining an erection. To use this device the penis is inserted into a cylinder, using plenty of lubrication to ensure a good seal at the base of the penis. A small vacuum pump is attached to the other end of the cylinder. The pump creates a vacuum and this causes blood to be drawn into the penis thus causing an erection. A constriction ring is then placed onto the base of the penis to trap the blood in the penis and maintain an erectile state. The cylinder is then removed. The ring can be left in place for up to 30 minutes.
This is a safe and effective form of treatment. In some instances these can be supplied by the NHS. The cost of a pump is between £120 and £300. The urology sister will demonstrate how to use the device.
Penile implants
This involves surgical implantation of two rods into each side of the penis. They can be semi-rigid or inflatable and are permanent.
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