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Treatment for Erectile Dysfunction

Treatment for
Erectile Dysfunction

Quick Links: ED Treatment Options | Important Safety Information

ED Treatment Options

Erectile dysfunction (ED) is not an inevitable part of aging.1 There are several treatment options depending on the reason for your ED.2 It’s important to explore and learn about all alternative treatment options.

Your doctor will be able to explain all your options and help you choose the best option for you. There are many options and suggestions your doctor may give you, such as making lifestyle changes (diet, exercise, better habits), trying medication or a vacuum erection device, or a penile implant.3

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Oral
Medication

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Vaccuum Erection
Devices

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Insertable
Medication

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Shot
Therapy

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Penile Implants
Coloplast Titan IPP, and
Titan Touch IPP

A penile implant offers a long-term solution for ED.4 It is an erection assistance device that is placed inside the body during a routine outpatient procedure. It allows for spontaneity and puts the man back in control of his body. Penile implants were designed to mimic the look and performance of a natural erection.5

For more information about penile implants, visit the Penile Implants page.

A penile injection is placed into the penis to inject medication to create an erection. This produces an erection within 5-20 minutes.6 Potential side effects include priapism (erection lasting 4 hours or more), penile pain, numbness or irritation, bruising at the injection site, and penile fibrosis (deformed penis shape).7
Insertable medications are another ED solution available but are not as commonly prescribed. A small pellet (suppository) is inserted into the urethra using an applicator and the pellet is released allowing for increased blood flow, creating an erection. Erections usually start within 10 minutes and last between 30-60 minutes. Side effects can include burning and aching in the penis and groin.8
pump Vacuum erection devices are external pumps placed over the penis to help with ED. The device, consisting of a cylinder and pump, creates a vacuum that pulls blood into the penis creating an erection and a constriction ring that helps maintain the erection. Patients that use vacuum erection devices may have a learning curve and may experience an erection that is not warm to the touch.9
Pills like Viagra™, Cialis™, Levitra™, or Stendra™ may help achieve erections in response to stimulation. They must be taken at least half an hour to one hour before anticipated sexual activity. Potential side effects include headaches, facial blushing, upset stomach, back pain/muscle aches, and nasal congestion.9

TM* Third party brands are property of their respective owners.

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Titan® and Titan® Touch Inflatable Penile Prosthesis – Important Safety Information

A penile implant, also called a penile prosthesis, is concealed entirely within the body to address erectile dysfunction (impotence). The implant requires some degree of manipulation before and after intercourse to make the penis erect or flaccid.

Indications
The Titan and Titan Touch Inflatable Penile Prosthesis is indicated for male patients suffering from erectile dysfunction (impotence) who are considered to be candidates for implantation of a penile prosthesis.

Contraindications
The Titan and Titan Touch Inflatable Penile Prosthesis is contraindicated in patients who have one or more of the following: (1) Patients with an active infection present anywhere in the body, especially urinary tract or genital infection. (2) Patients with a documented sensitivity to silicone. (3) Patients with unresolved problems affecting urination, such as an elevated residual urine volume secondary to bladder outlet obstruction or neurogenic bladder. (4) Patients unwilling to undergo any further surgery for device revision.

Warnings
Implantation of the device may make latent natural erections, as well as other interventional treatment options, impossible. Men with diabetes or spinal cord injuries, as well as immunocompromised patients, may have an increased risk of infection associated with a prosthesis. Implantation of a penile prosthesis may result in penile shortening, curvature or scarring.

Precautions
Removal of an implanted prosthesis without timely reimplantation of a new prosthesis may complicate subsequent reimplantation or may make it impossible. MRI quality may be compromised if the area of interest is in the exact same area or relatively close to the position of the Titan, and Titan Touch IPP. Be sure to consult with your physician. Patients should discuss all available treatment options and their risks and benefits with their physician. Health conditions which hamper sexual activity, such as severe chest pain (angina), may prevent successful use of this device. The prosthesis should not be implanted in patients who lack the manual dexterity or strength necessary to operate the device. Trauma to the pelvic or abdominal areas, such as impact injuries associated with sports (e.g., bicycle riding), can result in damage of the implanted device and/or surrounding tissues. This damage may result in the malfunction of the device and may necessitate surgical correction, including replacement of the device. The device may be used in the presence of Peyronie’s Disease.

Potential Complications
Penile implants are surgical solutions requiring a healing period that have risks associated with surgery such as scrotal swelling, auto-inflation, discomfort, angulation/curvature, swelling (edema), device malfunction, chronic pain, difficulty with ejaculation, transient urinary retention, fever, migration, patient dissatisfaction, infection at surgical site or wound, deflation, swelling of clotted blood or clear fluid (hematoma/seroma), wound leakage, bleeding, delayed wound healing, narrowing of the opening of the foreskin (phimosis), sensory loss, cylinder malfunction, formation of thick tissue (fibrous capsule formation), over/under inflation, erosion, scrotal reddening (erythema), genital change, and inguinal hernia.

This treatment is prescribed by your physician. Discuss the treatment options with your physician to understand the risks and benefits of the various options to determine if a penile implant is right for you.

Caution: Federal law (USA) restricts this device to sale by or on the order of a physician.
Genesis® Malleable Penile Prosthesis – Important Safety Information

A penile implant, also called a penile prosthesis, is concealed entirely within the body to address erectile dysfunction (impotence). The device is manually positioned to simulate an erect or flaccid penis.

Intended Purpose
The Genesis Malleable Penile Prosthesis is a flexible silicone elastomer device designed to be implanted into the penis for the management of erectile dysfunction (commonly known as impotence).

Indications
The prosthesis is designed for the management of erectile dysfunction (impotence) stemming from a variety of causes, including: epispadias (a rare birth defect located at the opening of the urethra), pelvic fracture; spinal cord injury or disease; prostatectomy; cystectomy; abdominal-perineal resection (surgical removal of the anus, rectum, and sigmoid colon); multiple sclerosis; diabetes mellitus; alcoholism; arteriosclerosis and hypertensive vascular disease; priapism (prolonged and painful erection of the penis); and Peyronie’s disease (curvature of the penis). The Prosthesis may also be used in selected patients with psychogenic impotence.

Contraindications
The Genesis Malleable Penile Prosthesis should not be used in: patients with an active infection present anywhere in the body, especially urinary tract or genital infection; patients with a documented sensitivity to silicone; and, patients with unresolved urinary problems, such as an elevated residual urine volume secondary to bladder outlet obstruction or neurogenic bladder.

Warnings
Implantation of a penile Prosthesis may make natural erections difficult to achieve. It may make some other interventional treatment options not possible. Implantation of a penile Prosthesis may result in penile shortening, curvature or scarring. Men with diabetes as well as immunocompromised patients, may have an increased risk of infection which could result in permanent damage to tissue/organs.

Consult with your physician if you are experiencing a change in rigidity or appearance of the erect penis. Replacement of the prosthesis may be necessary. If you have borderline bladder decompensation, an indwelling catheter, or enlargement of the prostate talk to your doctor.

Precautions
Patients should be informed that erections achieved with a malleable penile Prosthesis may differ from original erection (e.g. not of equal length or girth) compared to what was previously experienced with natural erections. Talk with your physician regarding realistic expectations. Health conditions which hamper sexual activity (e.g. severe angina) may prevent successful use of this device. Penile implants are not considered lifetime implants due to the inherent nature of mechanical devices. Trauma to the pelvic area, such as impact injuries associated with sports, can result in damage of the implanted device and/or surrounding tissues. This damage may result in the malfunction of the device and may necessitate surgical correction, including replacement of the device.

Potential Complications
Adverse events are known to occur with penile protheses procedures and implants; some may require revision surgery or removal of the implant. Adverse events following penile protheses implantation may be new (de novo), persistent, worsening, lasting for a short time (transient), or permanent.

Penile implants are surgical solutions requiring a healing period that have risks associated with surgery such as deformity, delayed / impaired / abnormal wound healing, injury to tissue or organs (erosion / extrusion / migration) resulting in damage or loss of tissue (necrosis), opening or tunnel between tissue or organs (fistula), allergic reaction or sensitivity to device, collection of blood or fluid outside of tissue or vessels (hematoma, seroma), bleeding or excessive bleeding (hemorrhage), infection, redness or swelling of tissue, irritation, penile implant moves (migration), penile tissue dying off (necrosis), pain/discomfort, inability to pull the foreskin forward over the tip of an uncircumcised penis (paraphimosis), inability to pull the foreskin back from the tip of an uncircumcised penis (acquired phimosis), perforation or injury of soft tissue (e.g., muscles, nerves, vessels), penile structures, or organs (e.g., urethra), scarring, difficulty during sexual activity, numbness or decreased sensation in penis, blockage or slowing of urine (urethral obstruction / occlusion), urinary tract infection, and difficulty emptying bladder.

The occurrence of these events may require one or more subsequent surgeries which may or may not always fully correct the complication.

This treatment is prescribed by your physician. Discuss the treatment options with your physician to understand the risks and benefits of the various options to determine if a penile implant is right for you.

Caution: Federal law (USA) restricts this device to sale by or on the order of a physician.

References

  1. Definition & Facts for Erectile Dysfunction. NIH: National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/definition-facts. Accessed March 2023.
  2. Benabdallah, Justin. Erectile Dysfunction. The James Buchanan Brady Urological Institute. September 2020.
  3. Treatment for Erectile Dysfunction. NIH: National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment. Accessed March 2023.
  4. Miller LE, Khera M, Bhattacharyya S, Patel M, Nitschelm K, Burnett AL. Long-Term Survival Rates of Inflatable Penile Prostheses: Systematic Review and Meta-Analysis. Urology. 2022 Aug;166:6-10.
  5. Data on file at Coloplast
  6. CAVERJECT® IMPULSE Medication Guide. ©2022 Pfizer Inc.
  7. CAVERJECT® IMPULSE What are the causes of and treatments for ED? ©2022 Pfizer Inc.
  8. MUSE™ (alprostadil) urethral suppository IFU. Meda Pharmaceuticals, Inc. Revised April 2018.
  9. Yuan J, et al. Vacuum therapy in erectile dysfunction – science and clinical evidence. International Journal of Impotence Research. 2010; 12: 211-219
  10. Cialis.™ Highlights of Prescribing information. Lily USA, LLC. Revised February 2018.