Medical Treatment

Several medications are available which can promote and help sustain a natural erection.  Viagra, Levitra, and Cialis all similarly help men respond to sexual stimulation.  When a man is sexually aroused, the arteries in the penis relax and widen, allowing for more blood to flow into the penis.  As arteries in the penis expand, the veins that normally carry blood away from the penis become compressed, restricting blood flow out of the penis.  With more blood flowing in and less flowing out, the penis enlarges, resulting in erection.

These medications, known as PDE-5 inhibitors, all act similarly to prolong and enhance the body’s natural potency mechanism.  They differ largely in their duration of action and side effect profile.  The appropriateness of these medications for each patient is determined by a review of one’s medical history and medication requirements.

Self Injection

Self injection involves using a small needle to inject medication directly into the erectile tissue of the penis, producing an erection that lasts from 30 minutes to a few hours.  These drugs have been shown to produce erection in 80% of men who inject them.  The injections are relatively painless and create an erection that begins about 5 to 15 minutes after the injection.  It is recommended that self injection be performed no more than once every 4 to 7 days.  Before therapy is prescribed, each patient receives a penile doppler ultrasound quantifying his degree of vasculogenic erectile dysfunction and specific teaching of proper injection dosage and technique.

Vacuum Erection Device (VED)

VEDs work by manually creating an erection.  The penis is inserted into a plastic tube which is pressed against the body to form a seal.  A hand pump attached to the tube or battery activated suction is used to create a vacuum that draws blood into the penis, causing the penis to become engorged.  After 1 to 3 minutes in the vacuum, an adequate erection is created.  The penis is then removed from the tube and a soft rubber O-ring is placed around the base to trap blood and maintain the erection until removed.  The ring can be left in place for 25 to 30 minutes.

Surgical Therapy - Penile Prosthetics

An inflatable penile prosthesis consists of two soft silicone tubes inserted in the penis, all through a single, small and imperceptible incision in the scrotum.  To produce an erection, a small pump placed in the scrotum is squeezed until sufficient fluid is transferred from a reservoir into the penile cylinders, achieving a firm erection.  When the erection is no longer desired, a valve allows the fluid to return to the reservoir with the simple push of a button on the same scrotal pump.  Inflatable prostheses are the most natural feeling of penile implants and allow for control of rigidity and duration of potency.  There is no loss of sensation during intercourse or in the ability to achieve an orgasm (ejaculate).

Type of Penile Implants

1. Three –piece, inflatable penile prosthesis (AMS CX700 & LGX-MS pump models)
2. Two-piece, inflatable prosthesis (AMS Ambicor)
3. Malleable, non-inflatable prosthesis (Dura II)

Dr. Cornell is respected as one of the nation’s foremost prosthetic urologists.  He specializes in placing both the three-piece inflatable penile implant and artificial urinary sphincter (AUS) through a single scrotal incision in a single surgical procedure.

3 - Piece Inflatable Penile Prosthesis

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