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Other treatments for ED
Penile injection therapy1
Medication that increases blood flow in the penis is injected by the patient into the side of the penis shortly before sexual activity.
Men with ED at the more severe end of the spectrum tend to find injections into the penis a more effective treatment than the tablets. Injections have been used in Australia since the mid-90s. Injections are only available on prescription and are usually recommended if:
- The tablets have not worked, or
- The individual is unable to use them for medical reasons1
The injections work by directly opening up the penile blood vessels. It may take between 5 and 10 attempts to master the technique.
After injecting, the drug will usually work within 5 to 10 minutes (with or without sexual stimulation) and ideally will last for 30 minutes.1
You should discuss any treatment involving injections with your doctor. A follow-up appointment is important to ensure you are correctly using the injection.
It is recommended to start injections at a lower dose, then work your way up to minimise the chance of a prolonged erection (called priapism), which can cause permanent damage. By working with your doctor, this risk can be minimised.
Some men will experience pain in the penis and sometimes scarring may occur.
Vacuum pumps2
The vacuum device is placed over the penis and, as air is pumped out of the cylinder, blood is drawn into the penis making it enlarge. A ring is then placed around the base of the penis to maintain the erection.
It is recommended that its use is limited to 30 minutes. The ring must be removed when this time has elapsed or there is a risk of permanent damage to the penis (i.e. it's important not to go to sleep with it on).
Your doctor will recommend where to purchase these devices.
Penile implant surgery3
This is an option for men with ED for whom other treatments have been unsuccessful. This is a device that is surgically inserted into the penis. The device is inflated when there is a desire for sexual intercourse.
Surgery requires a referral to a urologist, who will assess whether your erection problem is suitable for surgery and discuss details of the operation.
Penile implants are suitable for a small number of men. Some types require pressure to be applied to a small reservoir at the base of the scrotum. This pumps fluid into the implant tubes and makes them go firm to create an erection.
A surgical implant would only be likely to be considered when all other treatments have failed or are unsatisfactory for you.
Severe curvature of the penis (called Peyronie's Disease) may interfere with intercourse and this condition can also be surgically corrected.
Rarely there may be surgery on the blood vessels in the penis. This is called vascular surgery and is not performed very often for ED. It is a highly specialised procedure and is often not successful.
Sex counselling/sex therapy
Consultations with a trained counsellor or psychologist may help you identify, understand, and cope with sexual concerns.
While ED usually has a physical cause, it often has emotional impacts. Talk to your doctor and your partner if you need support and advice.
Sometimes ED is a direct result of an emotional situation without a physical cause. You might find it useful to talk to a sexual health or relationship counsellor – or contact Impotence Australia on 1800 800 614.
Some useful links:
www.relationships.com.au
www.relationshiphelponline.com.au
 Back to Treatment choices menu
1. Lue TF. Erectile Dysfunction. N Engl J Med 2000;342:1802-1813.
2. Nadig PW. Vacuum erection devices. World J Urol (1990) 8:114-117
3. Hatzichristou DG & Pescatori ES. Current treatments and emerging therapeutic approaches in male erectile dysfunction. BJU International (2001), 88(Suppl. 3), 11±17
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