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How Does a Urologist Treat Erectile Dysfunction?
Erectile dysfunction (ED) is one of the most common conditions treated by urologists, affecting millions of men—especially as they age. It’s defined as the persistent difficulty in getting or maintaining an erection firm enough for sexual intercourse. While occasional issues are normal, ongoing ED can point to an underlying health issue that needs attention.
Fortunately, urologists are trained to diagnose and treat ED using a range of proven options. From medication to lifestyle changes to advanced procedures, there are many ways a urologist can help restore sexual function and improve quality of life. Let’s take a closer look at how a urologist treats erectile dysfunction.
Step 1: Diagnosis and Evaluation
The first thing a urologist will do is gather information. They’ll ask about your symptoms, how long they’ve been happening, your sexual health history, and any other medical conditions or medications you’re taking.
A full evaluation may include:
- Physical exam – checking for nerve issues, blood flow, and signs of hormone problems.
- Blood tests – to evaluate testosterone levels, blood sugar, cholesterol, and signs of heart disease.
- Urinalysis – to check for diabetes or kidney issues.
- Ultrasound – to assess blood flow to the penis.
- Nocturnal penile tumescence test – to determine whether erections occur during sleep.
This process helps identify whether the ED is primarily physical, psychological, or a combination of both.
Step 2: Lifestyle and Health Changes
If the cause is related to lifestyle factors, your urologist may start by recommending simple changes that can make a big difference:
- Quit smoking – Smoking damages blood vessels, making it harder to maintain an erection.
- Lose weight – Obesity is linked to lower testosterone and higher rates of ED.
- Exercise regularly – Improves circulation and boosts energy and mood.
- Limit alcohol – Excessive drinking can reduce sexual function.
- Manage stress and mental health – Anxiety, depression, and performance pressure can all contribute to ED.
These changes may not provide instant results, but they can significantly improve overall health and sexual function over time.
Step 3: Oral Medications
The most common treatment for ED is oral medication. These are phosphodiesterase type 5 (PDE5) inhibitors that work by increasing blood flow to the penis:
- Sildenafil (Viagra)
- Tadalafil (Cialis)
- Vardenafil (Levitra)
- Avanafil (Stendra)
These medications are generally taken before sexual activity, and they only work when there is sexual stimulation.
Your urologist will determine:
- Which medication is best for you
- The appropriate dose
- Whether there are any interactions with other drugs you’re taking
Not everyone can safely use these medications, particularly men taking nitrates for heart disease, so a full evaluation is critical.
Step 4: Hormone Therapy
If bloodwork shows low testosterone levels, your urologist might suggest testosterone replacement therapy (TRT). This can be administered via:
- Injections
- Skin patches
- Gels
- Pellets placed under the skin
TRT may improve libido and energy levels, but it’s not a cure-all. It’s usually combined with other treatments for best results.
Step 5: Vacuum Erection Devices (VED)
A vacuum erection device is a non-invasive, drug-free option. It works by creating suction around the penis to draw blood into it. A tension ring is then placed at the base to maintain the erection during intercourse.
This is a good option for men who prefer to avoid medication or are not candidates for oral drugs due to health reasons.
Step 6: Penile Injections or Suppositories
For men who don’t respond to oral medications, a urologist might recommend penile injection therapy, which involves injecting medication directly into the side of the penis. Common drugs include alprostadil, papaverine, or a combination.
Alternatively, intraurethral suppositories (also using alprostadil) are placed inside the urethra using a small applicator.
These methods can produce a firm erection within minutes, but they require careful instruction and monitoring for side effects.
Step 7: Penile Implants
If all other treatments fail, a penile implant may be recommended. This is a surgical procedure where a device is placed inside the penis. There are two main types:
- Inflatable implants – allow the user to pump fluid into the penis for an erection and deflate afterward.
- Malleable (semi-rigid) implants – keep the penis firm but bendable for positioning.
Penile implants have high satisfaction rates among patients and their partners, but they are typically considered a last resort due to the surgical risks and recovery time.
Step 8: Treating Underlying Conditions
Sometimes, ED is a symptom of a more serious medical issue. Urologists may work with your primary doctor or other specialists to manage:
- Diabetes
- High blood pressure
- Heart disease
- Depression or anxiety
- Neurological disorders
When these conditions are better controlled, ED often improves as a result.
Final Thoughts
Erectile dysfunction is common, but it’s not something you have to live with. Urologists have the expertise and tools to uncover the root cause and offer a range of effective treatments—from simple lifestyle changes to advanced surgical solutions. If you’re in need of a urologist in Brooklyn, we recommend reaching out to us.
If you’re experiencing ED, don’t delay getting help. The sooner you talk to a urologist, the sooner you can find the right treatment and get back to feeling confident in your health and relationships.
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