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Erectile Dysfunction

Erectile Dysfunction Introduction

Recently, Mr. K.H., a man with Erectile Dysfunction (ED), contacted the Center for Reconstructive Urology looking for ED Treatment, expressing an interest in penile implants, also known as penile prosthesis. A penile implant is a device that is surgically placed inside of the penis to permit adequate rigidity for sexual intercourse to supplement the symptoms of erectile dysfunction. He wanted to know the cost of the implant as he was possibly interested in scheduling a surgery. Upon further questioning, Mr. H. indicated that he failed other treatments for impotence, was searching on the internet for the best doctor to perform the penile prosthesis placement, and identified Dr. Joel Gelman at UC, Irvine in Orange, California as an expert in penile implant surgery for a solution to erectile dysfunction. Mr. H. mentioned that he previously contacted another doctor he considered an expert based on internet research, and that the other physician was willing to give him a surgery date at the time of his phone call. However, Mr. H. wanted to first consider other doctors.

Dr. Gelman called him that day, and during a long conversation, explained that at the Center for Reconstructive Urology, we do not schedule patients for surgery without an initial consultation (that includes a physical exam) to first determine that a penile implant is truly the best treatment option for his erectile dysfunction. Our individualized approach is to extensively counsel patients regarding all options, explain the risks and benefits of each option, and favor the least invasive option that provides the desired result. This is actually a requirement for a patient to give informed consent for any treatment.

Mr. H, now our patient, indicated that he was first treated with Viagra, a pill to treat erectile dysfunction, also known as impotence, but that was not an effective ED treatment. He then mentioned that he was then treated with injection therapy at a clinic that advertised guaranteed results. This is an ED treatment where the patient injects a small amount of medication into the side of the penis using a very small needle. This was only partially effective as he did not achieve adequate rigidity. Upon further questioning, he said that he was not sure he was injecting himself correctly as he was never observed performing a self injection. In addition, he was not sure he ever tried the maximum dose. At the conclusion of the visit, Mr. H. decided to pursue injection therapy and not penile implants as his next step [to fix his erectile dysfunction.] He may not have an adequate result with injections, even using the correct technique at the maximum dose and then pursue an implant. Should he ultimately receive an implant, he will have that surgery knowing that he truly considered all alternatives, and will be confident that a penile implant is the best option for the treatment of his erectile dysfunction.

The sub-sections on the left side of this page provides information about the anatomy of the penis, an explanation of how erections occur, what causes erectile dysfunction, ED treatment options, and our approach to ED treatment at the Center for Reconstructive Urology.

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