Most men with ED are initially treated with an oral medication such as Viagra, Levitra, or Cialis by their primary care doctor or local Urologist. Contraindications to the use of these medications for impotence treatment include angina that is treated with nitroglycerine. If oral medication is not effective, not tolerated, or contraindicated, then alternatives are available.
This is a medication that is in the shape of a small pellet of medication. It it inserted into the opening of the urethra with an included disposable plastic applicator. This medication is vasoactive, which means that it promotes blood flow within the penis. Disadvantages include urethral discomfort and a significant percentage of patients do not achieve an adequate response.
This is also called a vacuum erection device or penis pump. This is a device that is placed over the penis. During use, a vacuum is created between the pump and the penis, promoting blood flow to the penis. Once the device is removed after an erection is achieved, if the penis soon becomes flaccid, then the vacuum device can be used in combination with an elastic constricting ring that is placed at the base of the penis after the pump is removed. The pump promotes the erection, and the ring helps maintain the erection. One advantage of this treatment option is that it does not require medication or surgery. One disadvantage is that men may find it cumbersome, and the need to use this device embarrassing and artificial.
Osbon Erecaid Vacuum Erection Device, Timm Medical
Penile Construction Rings, Osbon
ED treatment injection therapy involves the self administration of a small amount of medication into the side of the penis using a small needle and syringe. Our preference is to use a 3 drug combination, called “triple therapy” or “tri-mix” for penile injections. When our patients choose this treatment option, they are first taught exactly how to draw the medication into the syringe and perform the injection. They then demonstrate the ability to perform self-injection using saline. Only then is the medication ordered. These medications are combined at a specialty pharmacy called a compounding pharmacy. We call a compounding pharmacy and order the medication and supplies, to be delivered to the home of the patient. The patient is present at that time to provide credit card payment. The cost of the medication is approximately $70/5ml and $140/10ml.
Dr. Gelman and the Center for Reconstructive Urology receive no reimbursement or profit from the sale of oral medications, vacuum devices, or injection therapy medications. Dr. Gelman has no financial interest in the pharmacy that provides the medication, and has no financial relationships with any drug company or device manufacturer. Therefore, when a specific medication or product is recommended, our patients can be assured that there is no bias or even the appearance of a conflict of interest.