Page 2 - Erectile Dysfunction - Treatment Options
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Erectile dysfunction

             Treatment options



        Medications
        The treatment of ED has changed dramatically since        In general, MUSE™ is safe although there have been
        sildenafil (Viagra™) has been available. This is the first   a few reports of excessively prolonged erections
        of a new class of drugs called phosphodiesterase 5        (priaprism) requiring immediate medical attention.
        (PDE5) inhibitors which can enhance the relaxation
        of the penile blood vessel muscles to improve penile      Penile injection
        blood flow and promote erections. Newer PDE5
        inhibitors, tadalafil (Cialis™) and vardenafil (Levitra™),   A drug or combination of drugs can be delivered into
        have slightly different effects and side effects.         the penis by injection through a fine needle such as
                                                                  that used by diabetics. Most men can learn to inject
        PDE5 inhibitors can be used safely by most men with       themselves safely and effectively with little discomfort.
        the exception of those taking certain heart drugs (e.g.   An erection will come on about ten minutes after
        nitroglycerine). Side effects are usually short-lived.    injection and the dose of medication is adjusted so
        These include headache, upset stomach and nasal           that the erection will last about 30-45 minutes.
        congestion. Unfortunately, these drugs will not work
        for everyone.                                             Occasionally there can be mild pain or bruising after
                                                                  injection. Prolonged erections occur rarely but require
        Testosterone replacement                                  immediate medical attention to prevent permanent
        A few men with ED are found to have a very low level      penile damage.
        of the male hormone testosterone. These men may           Vacuum device
        have a low sex drive (interest in sex) in addition to their
        difficulty in getting adequate erections. When a blood    Blood can be drawn into the penis with a special
        test shows that the man’s testosterone level is very      vacuum device (“vacuum pump”). This is a plastic
        low, hormone replacement will sometimes improve           cylinder in which the penis is placed after which a
        function.                                                 vacuum is created by a mechanical or electric pump.
        Testosterone replacement can be given in pill form,       Once the penis is adequately engorged, an elastic
                                                                  band is slid from the cylinder onto the base of the
        by skin patch or gel rubbed into the skin, or by          penis to keep the blood from draining out. Intercourse
        injection every few weeks. Some doctors believe           is then possible. When the elastic band is removed,
        that testosterone replacement may alleviate the
        effects of andropause, the changes that a man may         the penis softens.
        experience with the normal decrease in testosterone
        production with age.                                      Surgery
        Testosterone may have side effects which should be        Surgery is now performed infrequently for the
        monitored by your doctor. Testosterone replacement        correction of ED. A few men, with blood vessel
        requires that the prostate be evaluated regularly         blockage preventing adequate filling of the penis
        given the known stimulatory effect of testosterone        will benefit from surgery to improve circulation.
        on the prostate.                                          As a last resort, flexible or inflatable rods can be
                                                                  implanted surgically in the penis to maintain stiffness.
        MUSE™                                                     Treatment is available for most men with ED such that
        MUSE™ (short for Medicated Urethral System for            their sex life and intimacy with their partner can be
        Erections) is a unique delivery system, in which a small   improved. The choice of treatment is determined by
        pellet of medication (the size of a grain of rice) is     the wishes of the man and his partner.
        placed in the urine passage (urethra) from where it is
        absorbed. This medication then causes increased the
        penile blood flow resulting in an erection.

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        The information in the publication is not intended to convey medical advice or to substitute for direct consultation with a qualified medical
        practitioner. The Canadian Urological Association disclaims all liability and legal responsibility howsoever caused, including negligence, for the
        information contained in or referenced by this brochure.                                   cua.org            32E-EDFE-01-07
        © 2014. Canadian Urological Association. All rights reserved.
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