At Kansas City Urology and Oncology, we treat many kinds of men’s urologic issues from enlarged prostate to prostate cancer. One of the most common issues we see is ED or erectile dysfunction. ED affects millions of men and is not only a physical problem, but it can cause relationship trouble as well due to its effect on intimacy. Luckily, there are many different treatment options available.
Dr. Nate Ballek, prosthetic urologist and men’s health specialist with KCUC, recently recorded a men’s health webinar titled “Signs, Symptoms, and Treatment Options for Erectile Dysfunction and BPH” where he addresses erectile dysfunction and explains all of the ways it can be treated as well as BPH (enlarged prostate) symptoms and treatments. We are focusing exclusively on ED in this article, but here is a link to that webinar if you prefer to watch it: Signs, Symptoms, and Treatment Options for Erectile Dysfunction and BPH
Understanding Erectile Dysfunction (ED)
Erectile dysfunction (ED) is the inability to achieve or maintain an erection sufficient for sexual intercourse. While it can affect men as young as their 20s, it becomes more prevalent with age. By the time men reach their 40s, the likelihood of experiencing ED increases and it continues to rise with each passing decade. Today, nearly 40 million men in the U.S. are affected by ED.
Understanding How Erections Function
Erections involve a complex process that requires proper function of the nerves, arteries, and veins. When a man becomes aroused, nerve signals prompt blood vessels in the penis to dilate, increasing blood flow. This pressure traps blood in the penis, maintaining an erection. Once stimulation ends, the blood flow decreases, and the erection subsides.
ED occurs when one or more of these systems fail. Common causes include vascular disease, diabetes, nerve damage, medications, and even prostate cancer treatments like surgery or radiation. Since ED can significantly impact quality of life and intimate relationships, it is important to understand the various treatment options available.
Common Causes of ED
1. Diabetes
Diabetes is one of the most severe causes of ED. High blood sugar damages nerves and blood vessels, affecting the ability to maintain an erection. Nearly 50% of men with diabetes experience some form of sexual dysfunction. The condition is also more resistant to common ED treatments.
2. Heart Disease
Since erections rely on healthy blood flow, conditions that affect the arteries – such as high cholesterol and heart disease – can contribute to ED. In fact, ED may present three to five years before a heart attack, making it an early warning sign of cardiovascular disease.
3. Low Testosterone
Low testosterone levels (Low T) can contribute to ED, along with symptoms like fatigue, mood changes, and loss of libido. Treating Low T with testosterone replacement therapy can help improve overall sexual function in some men.
4. Prostate Cancer Treatments
Surgery and radiation for prostate cancer can damage the delicate nerves responsible for erections. While some men regain function over time, others experience long-term ED. Radiation-induced ED typically develops over several years due to gradual nerve and blood vessel damage.
5. Peyronie’s Disease
Peyronie’s disease involves the formation of fibrous scar tissue in the penis, leading to curvature and erectile difficulties. While the exact cause is unknown, it is thought to result from an immune system response and defects in collagen production.
Treatment Options for ED
At KCUC, we offer a variety of treatment options, ranging from oral medications to surgical implants. The best option depends on the underlying cause of ED and a patient’s lifestyle.
1. Oral Medications (PDE5 Inhibitors)
Drugs like Viagra (sildenafil), Cialis (tadalafil), and Levitra (vardenafil) work by increasing blood flow to the penis. These medications are effective for about 85% of men. However, they are not instant solutions and require proper timing and sexual stimulation.
Side Effects:
- Headaches
- Facial flushing
- Nasal congestion
- Upset stomach
Who Should Avoid Them? Men taking nitrates for heart disease should not use PDE5 inhibitors, as the combination can cause a dangerous drop in blood pressure.
2. Vacuum Erection Devices (VEDs)
A vacuum erection device uses suction to draw blood into the penis, followed by a constriction ring to maintain the erection. While effective, some men find the process cumbersome and less spontaneous.
3. Urethral Suppositories & Injections
Urethral Suppositories: These contain alprostadil, a medication that helps dilate arteries. However, some men experience discomfort or a burning sensation during use.
Injections: These involve directly injecting medication into the penis. While highly effective, the idea of self-injection can be daunting for some men. Once patients become comfortable with the process, satisfaction rates are high.
4. Penile Implants
For men who do not respond to other treatments, a penile implant offers a permanent solution. This surgical procedure involves placing inflatable cylinders inside the penis, a pump in the scrotum, and a fluid reservoir in the abdomen. Squeezing the pump moves fluid into the cylinders, creating an erection.
KCUC has been designated an AMS 700 Center of Excellence. This designation recognizes the KCUC team, and specifically Nate Ballek, MD, for his expertise with the AMS 700 IPP, an inflatable penile prosthesis created by Boston Scientific as a long-term treatment option for erectile dysfunction.
Benefits of Penile Implants:
- Allows for spontaneous intimacy
- Maintains sensation and ejaculation
- Highly discreet (completely internal)
- Over 90% patient and partner satisfaction rates
Risks:
- Surgical risks such as infection or mechanical failure
- Possible need for replacement surgery
- Higher infection risk for patients with uncontrolled diabetes
ED is a common condition, but it doesn’t have to diminish your quality of life. Whether through lifestyle changes, medication, or a surgical solution like a penile implant, help is available.
Compassionate, Patient-Centered Care
Kansas City Urology & Oncology (KCUC) is dedicated to providing expert care for men’s health issues, from erectile dysfunction to prostate cancer treatment. When considering ED treatments, it’s important to have an open conversation with your partner and your doctor. At KCUC, our commitment to excellence extends beyond medical expertise. We understand the emotional and physical challenges of urologic and oncologic diagnoses and we believe in treating each patient as a whole person. By emphasizing emotional support alongside physical health, we strive to reduce stress and anxiety, providing holistic care to make your healthcare journey a little easier. We call it Patient-First Care. At KCUC, you can trust that you are receiving advanced, compassionate care from a team of board-certified urologists and oncologists dedicated to achieving the best outcomes.
If you’d like to learn more about KCUC and our ED treatment options, contact one of the over 30 KCUC Urology and Oncology locations throughout Kansas and Missouri and schedule an appointment to see Dr. Ballek or one of our other board-certified urologists to explore your ED treatment options and regain confidence in your sexual health. At KCUC, you see the best in KC.
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