A diagnosis of erectile dysfunction can be difficult to deal with, but together we will navigate treatment options. The process of erection, sexual intercourse, and orgasm requires a highly coordinated response from the neurologic, vascular, psychologic, and sensory systems. The penis should be thought of as an inflatable rod and the cardiovascular (heart) system is the pump that inflates the rod. If the blood vessels in your heart are not functioning well, it is likely that blood vessels in your penis are not functioning well. Among many causes of erectile dysfunction are things like coronary artery disease, neural compromise from spinal problems or trauma, diabetes, smoking, drug use including alcohol and marijuana, etc.
If you are safe for sexual activity, this means that you can walk up 2 flights of stairs without getting winded, short of breath, chest pain, or dizziness then the 1st treatment option is an oral medication like sildenafil or tadalafil, the active ingredients in Viagra and Cialis, respectively. Certain populations such as diabetics, post prostate cancer surgery, post pelvic surgery, or Peyronie’s disease patients can commonly fail ED medications.
When a VED is used for sexual activity it is often used in conjunction with a penis ring that fits around the base of the penis
A 2nd treatment option is a Vacuum Erection Device (VED). This is a plastic tube that fits over the penis and pressed against the base of the penis and pubis. It then uses suction via a hand or battery-powered pump to pull blood into the phallus and cause engorgement.
When it is used for sexual activity it is often used in conjunction with a penis ring that fits around the base of the penis to trap the blood in after the vacuum pulls the blood into the penis. This cannot be used with the ring for more than 30 minutes at a time. Patients have reported in the past that this can cause a less then supported rod from a wobbly base or the sensation of a cold glans penis. For sexual activity the VED must be used with the ring for most patients. Discuss with your doctor if you take anticoagulation medications (Coumadin, aspirin, Plavix, Warfarin, Lovenox, etc), as these can sometimes be prohibitive of use.
The 2nd use for a vacuum erection device can be maintaining penile length in the face of increasingly severe erectile dysfunction
The 2nd use for a vacuum erection device can be maintaining penile length in the face of increasingly severe erectile dysfunction. This is certainly used for patients who have had prior prostate surgery or other radical pelvic surgery, but also any patient who has more severe erectile dysfunction in which the loss of nocturnal erections occurs. Typically, nocturnal erections occur to engorge and stretch the penile tissue and revitalize the blood-filled capillaries with oxygen. In many more severe forms of ED loss of nocturnal erection occurs. In this case, the vacuum erection device is used 3-5 times per week for approximately 20-30 minutes at a time with no penile ring. This is to cause engorgement in and stretching of the phallus. This is thought to be helpful because it can otherwise prevent shortening from decreased blood flow and stretching. Caution again should be advised for patients taking anticoagulant medications.
Stay tuned for further options beyond a VED as 2nd and 3rd line therapies for ED. Together we will find a cure to get that function and confidence back in your life.
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Jared J. Wallen MD
YOU & WEE Urologic Surgery and Wellness
Tampa Bay Area, FL
Phone: (941) 212-1600