What next for ED after trying everything.

[philmoff17]

I have been a ED patient for awhile. What other intervention is out there??

[specialmom]

The first thing to do is to look for any underlying cause.  This requires a medical examination.  It can be associated with several things such as  cardiovascular issues, diabetes smoking, medicine you may be taking, hyper tension, previous pelvic surgery, neurological issues, sedentary lifestyle, and a huge one, psychological issues,  etc.  It's a pretty long list that they will want to see if it is associated with any of these.  And if so, then working on those issues could help the ED. They'll give you a physical exam and ask you a whole slew of questions.  

Then they can make some changes, even lifestyle change suggestions for you that MAY rally help overcome the issue.

Treatment when working on underlying issues (including psychotherapy for any mental health hang ups with erections) would include the well known pharmacologic agents used and given by prescription.  Second line they go to Alprostadil or the vacuum pump. There are alternative therapies that I see no proof work.  :>)  Unproven, unstudied in a scientific way with a lot of claims that aren't backed up by science.  They are often making money there but without the proof so be careful with those. And there is behavior modification therapy.  

But likely you will have one of the underlying causes leading to your ED and if you work on that, it should improve.  good luck

[BonzoDog]

Good advice, specialmom. I'm 4 months post-surgery from Prostate Cancer & still not experiencing erections, even with Sildenafil (my function before surgery was 100% - no ED issues at all). Using a vacuum pump (on Dr's advice) to try to pull blood into the chambers so that tissue doesn't atrophy while the nerve damage heals. Penis gets significantly larger when using it, but not really 'stiff'. Normally when Viagra or other ED meds don't help, there's the vacuum pump & injections. The injections seem to work for about 85-90% of men. If that fails, there are penile implants that allow an erection - they insert inflatable prostheses on each side of the penis that function like the chambers that normally fill with blood. The man then uses a small 'pump' inserted near the scrotum that fills these with fluid, causing an erection. I've read that most guys are reasonably satisfied with the results of these implants. That's pretty much the last resort if all other measures fail. Unfortunately, it's not cheap & I don't think most Insurance covers the procedure...