The ED Spectrum

Erectile dysfunction varies, ranging from a total inability to achieve erection, to an inconsistent ability to do so, or having only brief erections. In older men, ED usually has a physical cause, such as disease, injury, or side effects of drugs. But it is not an inevitable part of aging. ED is treatable at any age.

ED can be a result of other conditions

Diseases, such as diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurologic disease, account for about 70% of ED cases. Between 35% and 50% of men with diabetes experience ED.

A side-effect of certain surgeries

Surgery (especially radical prostate and bladder surgery for cancer) can injure nerves and arteries near the penis, causing ED. Injury to the penis, spinal cord, prostate, bladder, and pelvis can lead to ED by harming nerves, smooth muscles, arteries, and fibrous tissues.

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The most common initial treatment for ED is oral medication (Viagra®, Levitra®, Cialis®), which is taken prior to sexual activity and increases blood flow into the penis. Your doctor will review all your medications, because certain drugs, especially nitrates, can cause an unsafe drop in blood pressure when combined with ED pills.

Urethral suppository is a system for inserting a pellet of alprostadil into the urethra to initiate an erection within 8 to 10 minutes.

The VED is a hollow tube that is placed over the penis and an attached vacuum pump (manual or battery-powered) is used to pull blood into the penis to create an erection. After an erection is achieved with the pump, a tension ring is placed at the base of the penis to maintain the erection during sexual activity.


Some men achieve stronger erections by injecting drugs into the base or side of the penis using a very fine needle. Penile injection drugs include papaverine hydrochloride, phentolamine, and alprostadil cause blood to flow into the penis to produce an erection.

A penile implant is a medical device that is implanted into the penis during a surgical procedure. A malleable implant remains firm permanently and is simple to use — it is manually positioned into an erect state. An inflatable penile implant (IPP) allows the user to inflate the implants with pressurized fluid via a small pump that has been surgically placed under the skin of the scrotum. Inflatable implants can expand the length and width of the penis somewhat and leave the penis in a more natural state when not inflated.

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