Erectile Dysfunction

What causes an erection?
Mental and/or physical arousal causes an increased blood flow into chambers inside the penis. These chambers swell and squeeze the small veins in the penis so that blood cannot escape. An erection is thus produced. When arousal stops, the action is reversed — the chambers allow blood to flow from the penis and back into the veins.

What causes impotence?
Impotence, ED, is caused by any condition that impedes blood flow into the penis. Spinal cord injury, hardening of the arteries, nerve damage from surgery or injury, and scar tissue are the most common. Psychological problems are NOT the most common cause of ED, but can exacerbate the problem. Knowing the true cause is the first step to reversing ED.

Why would I want an implant?

No one should be embarrassed by an implant. To the contrary, an implant is used to correct a physical problem, just as a synthetic joint might be used to repair a knee or hip. Besides, an implant is a sure sign that you are eager (and able) to enjoy an active and fulfilling sex life. No other treatment approaches the success level and satisfaction rating of the penile implant.

How noticeable is the implant?
The penile implant is virtually unnoticeable. In fact, a patient reported feeling confident that if he was in a locker room with three of his closest friends, the friends would never detect anything out of the ordinary. Patients report comments from their partners ranging from "no difference" to "improved" to "he can last longer." You might notice, however, that the head of the penis isn’t as firm as with a natural erection, and an erect penis isn’t quite as long as a result of this.

How does an implant work?
A penile implant is an outpatient procedure. The implant is a prosthesis that has been surgically implanted through a one inch incision into the penis. There are several types, and they work differently. The most advanced implants — and those that deliver the greatest level of patient satisfaction — are referred to as "three-piece" inflatables. To create an erection, an elongated cylinder in the penis is easily inflated via a tiny pump implanted in the scrotum. When the erection is no longer desired, a tiny release valve on the pump is pressed and the cylinder deflates. The erection is quite natural and can be maintained for as long as desired. The implant is virtually unnoticeable.

Do implants ever break?
Unfortunately, yes. But technology has greatly improved reliability and longevity in recent years — and most implant products now carry a lifetime warranty. If a revision is necessary, it is important to note that a re-operation is considerably less complicated than the original surgery and usually requires no more than a correction of a minor hydraulic problem. Even with the possibility of revision surgery, the long-term success rate of an implant is vastly superior to that of any other remedy for ED.

How safe are implants?
Recently, the U.S. Food and Drug Administration (FDA), began a reexamination of 20 years of penile implant history in order to determine if there are any hidden health or psychological problems in the patient population of over 200,000 men who have reversed their impotency with an implant. Specifically, authorities are interested in complications similar to those associated with silicone gel breast implants. While the study is not complete, preliminary results have shown no problems to be silicone related. Penile implants have components of medical grade silicone (as do knee cap, hip joint and heart valve replacements) and are filled with saline solution — not silicone gel. Penile implants bear no resemblance to silicone gel-filled breast implants.

How much does an implant cost?
The cost of the implant procedure varies widely depending mostly on the type of implant device used. IUE locations can quote all-inclusive pricing for the procedure, including transportation to and from the airport and hotel, and assistance with local accommodations. If the ED has a medical cause (most often the case), the cost of an implant procedure is usually covered by health insurance or by Medicare.

How do I choose a doctor for impotence?
ED is a special disorder. You will be best served by choosing a physician specially trained to treat it effectively. Very few physicians have this specialized interest and training in ED. In fact, implant manufacturers report that 90% of all implant surgeries are performed by just 3% of urologists in America. Our physicians are specialists in all aspects of diagnosing and treating ED. To find the IUE physician nearest you, CLICK HERE.

How does Viagra® work?
Viagra® (sildenafil citrate) can help many men get and keep an erection with sexual stimulation. Our experience indicates that it works about 60% of the time for about 50% of men with ED. These figures are misleading because, over time, the dosage must be increased and the effect is lessened. It’s ironic that best male enhancement pills work best for those who need it least, since the more the blood flow to the penis is impeded, the less effective Viagra is.

What's the latest on other research?
Pharmaceutical companies are researching the use of nitric oxide in treating ED. The research is promising and years from now, a product may reach the market. However, the penile implant remains the best option today for a long-term solution to ED.

What about injection therapy?
A small amount of medication is injected directly into the penis using a tiny needle similar to those used for insulin injections. The medication dilates arteries and relaxes the smooth muscle of the erectile chambers. Blood flow through the penis is facilitated and the erection is natural and rigid. Many couples complain that it tends to spoil the spontaneity of the sexual experience. Injections can sometimes cause an erection that will not go away. An erection lasting over four hours is a dangerous medical condition which must be treated immediately. Any man with this condition is urged to immediately seek treatment in the nearest hospital emergency room.

How about vacuum devices?
External vacuum therapy is a mechanical method of filling the penis with blood, simulating a natural erection. The penis is placed in a vacuum chamber or cylinder which draws blood into the erectile tissue of the penis through suction. Erection is maintained by trapping the blood in the penis using a tight elastic band at the base of the penis. Some devices can cause damage to the circulatory system. Consult with a urologist who specializes in ED before you try one. Our physicians specialize in ED treatments, are knowledgeable about many devices, and are comfortable discussing them.