Appropriate treatment options should be applied in a step-wise fashion, balancing invasiveness and risk versus efficacy. If possible, the partner should be involved in the decision-making. The decision depends on the patient preferences and expectations as well as the experience and judgment of the physician. Oral phosphodiesterase type-5 inhibitors are first line therapy.
Exercises have helped many with erectile problems. For a normal erection to happen, .
Besides PDE5 inhibitors and among second-line therapies are VCDs which are clear plastic chambers placed over the penis, tightened against the lower abdomen with a mechanism to create a vacuum inside the chamber. This directs blood into the penis. If an adequate erection occurs inside the chamber, the patient slips a small constriction band off the end of the VCD and onto the base of the penis. An erection beyond 30 min is not recommended. These devices can be a bit cumbersome, but are very safe.40
If these fail to improve symptoms, second-line treatments include a topical cream (alprostadil, prostaglandin E1) which works by relaxing the blood vessels, improving blood supply to the penis, and so causing an erection. Alternatively, alprostadil (prostaglandin E1) may also be injected into the penis, to relax blood vessels
Urinalysis (urine test, drug test) is a test performed on a patient's urine sample to diagnose conditions and diseases such as urinary tract infection, kidney infection, kidney stones, and inflammation of the kidneys, or screen for progression of conditions such as diabetes and high blood pressure.
Medicines to help produce erections – pills such as sildenafil (Viagra®), tadalafil (Cialis®), or vardenafil (Levitra®) − are typically used in combination with other therapies or devices. Since the drugs might not produce an erection because they need the nerves responsible for erections to be healthy, penile injections or vacuum devices might be offered. See Managing Male Sexual Problems Related to Cancer to learn more.
Background A growing body of evidence suggests that physical activity and exercise may improve erectile function.
This exercise is performed in a standing position. You have to stand straight with the feet apart equal to the width of hips and arms by side. Now squeeze the pelvis muscles with an exhale at the account of three. After squeezing, release the pelvis muscles with an inhale at the count of three. Again advise the select the right group of muscles. If you are not targeting the right muscles, you will have to face the music. Any type of carelessness can produce further problems. To consult the doctor and learn the right way of exercise is the best option for you.
If unsuccessful, interferes with other treatmentsFully Inflatable ImplantsMimics natural process of rigidity-flaccidity
If erectile dysfunction is caused by a blockage in an artery leading to the penis, surgery can be used to restore blood flow. Optimal candidates are typically younger men whose blockage stems from an injury to the crotch or pelvis. The surgery is not recommended for older men with widespread narrowing of the arteries throughout their bodies.
All PDE5i medication does not improve erections in normal men, only in those with difficulty in achieving or maintaining erections sufficient for sexual intercourse due to a true medical problem.
Don’t hold your breathDon’t push down — instead, squeeze your pelvic muscles together tightly as if you are trying to lift something up with those musclesTry to keep your stomach muscles relaxed throughoutRelax your pelvic floor muscles between each squeeze
If you smoke, talk to your doctor about quitting and whether prescription aids can help you.
Monitoring erections that occur during sleep (nocturnal penile tumescence) can help you and your doctor to understand if the erectile dysfunction is due to psychological or physical causes. The nocturnal penile tumescence test is a study to evaluate erections at night. Normally men have three to five erections per eight hours of sleep. The test can be performed at home or in a sleep lab. The most accurate way to perform the test involves a special device that is connected to two rings. The rings are placed around the penis, one at the tip of the penis and the other at the bottom (base) of the penis. The device records how many erections occur, how long they last, and how rigid they are. The test is limited in that it does not assess the ability to penetrate.
There are several different types of injection therapy ranging from injection of a single chemical (monotherapy) to a combination of chemicals, Bimix and Trimix. The selection of which therapy to use will vary with the severity of your erectile dysfunction and whether or not you tried and had pain with MUSE.
Picture of vacuum device in action. This image demonstrates the vacuum device in place. Note the presence of the constricting ring at the base of the penis.
Pelvic floor muscles can be identified by attempting to stop the flow of urine mid-stream. These are the muscles that will be used. Start with an empty bladder and tighten the pelvic floor muscles for 5 seconds, then relax for 5 seconds. Attempt to do 5 repetitions (reps) the first day. Work up to 10 seconds at a time. Aim for 3 sets of 10 reps daily. Avoid tightening muscles in the abdomen, thighs, or buttocks and avoid holding your breath. QUESTION Testosterone is a chemical found only in men. See Answer Men's Health Resources When Prostate Cancer Spreads12 Devices That Can Help Your Low Vision https://bjui-journals.onlinelibrary.wiley.com/doi/pdf/10.1111/j.1464-410X.2005.05690.x https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3275865/