The easiest, and most popular, way to treat erectile dysfunction (ED) is with one of three FDA-approved medications for this problem.
If pills don’t work, that’s a sign of more severe damage to either the blood vessels or nerves involved with erections. The remaining options include: penile-self injection; intra-urethral suppositories; vacuum devices; and penile implants.
Injections are made with a short, fine needle into the side of the penis. Although most men wince at the thought, the injections are virtually painless. An erection is generally obtained within minutes of the injection and can last from a half-hour to an hour. A variety of drugs are used and a number of different injection systems are available.
An alternate way to deliver the medication is in the form of a tiny pellet deposited about an inch into the penis by inserting an applicator tube into the opening at the tip. The pellet dissolves and an erection will begin within eight to 10 minutes. Discomfort is fairly common, with the most common side effects including an aching in the penis, testicles, and area between the penis and rectum; warmth or a burning sensation in the urethra; redness from increased blood flow to the penis; and minor urethral bleeding or spotting.
Mechanical vacuum devices cause an erection by creating a partial vacuum, which draws blood into the penis, engorging and expanding it. The devices have three components: a plastic cylinder, into which the penis is placed; a pump, which draws air out of the cylinder; and an elastic band, which is placed around the base of the penis to maintain the erection after the cylinder is removed by preventing blood from flowing back into the body.
If none of these methods work and the erectile dysfunction is severe, penile implants can be surgically installed. The most common implants are fluid-filled hydraulic devices that allow a man to have a modest erection at any time he wants by pumping fluid into two inflatable chambers implanted in the penis.
The disadvantages of implants are their high cost, the discomfort and risks of surgery, and the fact that the erections obtained, while sufficient for intercourse, are usually not as robust as those obtained in men with less severe dysfunction who use other methods.