Erectile Dysfunction

Erectile dysfunction, also known as impotence, is a medical condition that prevents a man from having an erection firm enough for sex. According to the National Institute of Health, as many as 30 million men suffer from erectile dysfunction. It is estimated erectile dysfunction affects:

  • 12 percent of men younger than 60
  • 22 percent of men between ages 60 and 69
  • 30 percent of men older than 70

An erection occurs when the penis receives nerve signals causing arteries to dilate. Blood flow then increases to the erectile tissue of the penis. The blood that flows into the penis must then be trapped to maintain an erection.

Erectile dysfunction is typically divided into two categories — psychogenic and organic. Most cases are organic, which are typically caused by diseases of the nervous system, such as diabetes; disorders of the circulatory system, such as arteriosclerosis; or disorders allowing blood to leak out of the penis prematurely, which is also called venous leak impotence.


To determine a cause and treatment options, physicians evaluate a patient’s detailed medical history and look for obvious causes such as medications known to be linked to erectile dysfunction. Physicians then take into account the patient’s lifestyle, such as smoking and illicit drug use, which can affect a man’s ability to obtain an erection. Other health conditions are addressed as well. Medical history is important. For example, a man who has a history of decreased sex drive may have deficient production of the male hormone testosterone.

Testosterone is the hormone responsible for the physical transition into manhood. It helps with gaining muscles, facial hair, and a deeper voice. Testosterone levels also affect a man’s sex drive and erections. Aside from the sex-related symptoms, low levels of testosterone, called hypogonadism or Low-T, are characterized by increased body fat, low iron, lower energy, depression, and reduced muscle mass.

In addition to a thorough medical history and physical examination, physicians will also conduct baseline blood testing to determine if the testosterone levels are adequate. In some cases, nocturnal penile tumescence monitoring is conducted to evaluate the quality of the patient’s nocturnal erections. This is important because men normally have multiple erections during various phases of the sleep cycle, and if there is a significant decrease then the erectile dysfunction is more likely to be organic than psychogenic.

Testing will help determine if the ED is organic or psychogenic. Most men will be found to have organic impotence and treatment options will be discussed. Some men will be found to have psychogenic impotence and will be referred for counseling.


While counseling is the best option for psychogenic impotence, there are a variety of non-surgical and surgical erectile dysfunction treatments for men dealing with organic impotence. Your physician can help you decide which treatment is best for you.

Non-surgical procedures

Surgical procedures

Frequently Asked Questions

Are there any oral medications used for treating impotence?
Viagra®, Levitra® and Cialis® are effective and safe oral agents for appropriate candidates. For example, men with a history of cardiovascular disease and especially men who are currently taking agents from the nitroglycerine family are not candidates for treatment with this class of drugs.

Are there any other non-surgical impotence treatments?
Yes. The vacuum constriction device is another excellent non-surgical treatment option. This system uses a plastic cylinder that is placed over the penis; a small pump is then used to create negative pressure, which acts to “pull” blood into the penis – producing an erection. A rubber band is then applied to the base of the penis, so that blood is trapped in the erect penis to sustain the erection until the band is removed.

What are my options if non-surgical impotence treatments don't work?
Penile implant surgery is always an option for men who aren’t happy with other treatments. We can do most penile implant procedures on an outpatient basis with a relatively short recovery period.

What kinds of non-surgical therapies are available for men with impotence?
Caverject® is one popular form of treatment. The therapy involves medication that is directly injected into the penis to produce an erection.

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