Sexual Wellness

What Can A Urologist Do For Erectile Dysfunction (ED)?

Fact Checked

Many men suffer from erectile dysfunction. See our guide on how a Urologist can help you treat your erectile dysfunction.

Last Updated: 04/14/2022

Written by

Eric Ridenour

Medically Reviewed by

Dr. Paul Thompson

Erectile dysfunction (ED) is a major sexual health problem affecting more than 30 million men in the United States who cannot maintain normal erections. Its prevalence has been estimated to be as high as 50% in some populations, and its occurrence increases with age. 

In addition, erectile dysfunction is associated with other health problems, such as coronary artery disease, depression, urinary tract infections, mental illness, heart disease, low blood sugar, low testosterone, other sexual issues, and osteoporosis. 

The prevalence of erectile dysfunction increases with age, with up to half of the men aged 60-70 years affected, along with low testosterone. ED is a common and potentially disabling condition with other underlying conditions that affect the quality of life. 

Your primary care doctor will often tell you that sexual dysfunction is common. Many men have sexual problems in their personal life or other condition related to the male reproductive system. There are two types of ED: organic and psychogenic.

Specialists for erectile dysfunction

Many specialists treat erectile dysfunction symptoms or other sexual problems, including sexual health specialists, psychologists, psychiatrists, urologists, cardiologists, endocrinologists, and others, who can provide effective treatments for people with erection problems.

You may have the opportunity to work with a sex therapist or a sex counselor, or you may choose to consult a general health care practitioner. Your health care professional will provide you with specific treatment recommendations.

What can a urologist do for erectile dysfunction?

Many men are unaware that they have ED, and the condition can be overlooked or undiagnosed for years. For some men, lack of a prolonged erection is nothing to be concerned about. For others, they get an erection, but can’t keep a firm erection. In addition, men with ED often have other health concerns so they do not notice.  

If you have ED, your urologist can help you determine the cause of the problem and perhaps even hidden risks such as a urinary tract infection or issues involving penile nerves. If the problem is related to medical conditions, your urologist may refer you to a specialist for evaluation and treatment. 

The specialist may perform a physical, evaluate the situation with a testicular examination, and order blood tests or urine tests to assess the cause of the problem, such as low blood sugar. Your urologist can also help you with specific treatments.

In addition to a complete medical history and physical exam, these specialists may order blood tests to evaluate the cause of ED. They may also perform other tests, such as a penile erection test, to assess the function of the nervous system and the muscles of the penis. A physical is the first step in the evaluation of ED. They may also ask if you frequently drink alcohol, as drinking is a common cause of erectile dysfunction. 

A complete physical by your doctor should include the following:

  • Medical history The patient should be asked about his sexual function, medications, alcohol use, and smoking history.

  • Physical examination The patient should be examined for abnormalities in the groin, neck, and testicles.

  • Genital examination The patient should be examined for a swollen penis, discharge from the penis, and lesions or lesions in the genital area.

  • Testicle examination The patient should be examined for tenderness, swelling, and discharge from the testicles.

Many men are unaware that they have ED, and the condition can be overlooked or undiagnosed for years. If you have ED, your urologist can help you determine the cause of the problem. Your urologist can also help you with specific treatments.

Erectile Dysfunction Treatment Options

There are several potential treatment options for erectile dysfunction; they range from simply taking a prescription medication to penile injections and other treatment options for related issues such as prostate surgery to treat ED.

There are a variety of standard treatment options for erectile dysfunction. These include:

Treatment with a vacuum erection device

A vacuum erection device (penis pump) is a mechanical device placed over the penis. It provides a partial vacuum, which results in an erection. The device can be used to treat mild to moderate ED. It is most often used in conjunction with a drug to help maintain the erection.

Treatment with a penile prosthesis

A penile prosthesis is a surgically implanted device that is used to treat severe ED. The device is surgically implanted into the penis. The device consists of a cylinder placed into the penis and a pump, which is placed under the skin in the scrotum. The pump is connected to the cylinder by a tube. The cylinder is filled with a gel that helps 

Treatment with intracavernosal injection

A penile injection can be used to treat mild to moderate ED. It is most often used in conjunction with a drug to help maintain the erection.

Treatment with a nerve stimulator

A nerve stimulator is a small electrical device that is surgically implanted into the penis. It can be used to treat severe ED. The device is connected to a wire that is placed into the penis. It stimulates the nerves that help the penis to become erect.

Treatment with a prosthesis

A prosthesis is a surgically implanted device used to treat severe ED. The device is surgically implanted into the penis. The device consists of a cylinder placed into the penis and a pump, which is placed under the skin in the scrotum. The pump is connected to the cylinder by a tube. The cylinder is filled with a gel that helps the penis to become erect.

Treatment with a penile implant

Penile implants are devices implanted into the penis to help men with erectile dysfunction (ED) achieve an erection. When other ED therapies fail, penile implant surgery is usually advised. Penile implants are classified into two types: semi rigid and inflatable.

  • Semirigid: Semirigid devices are invariably firm. For sexual activity, the penis can be bent away from the body, whereas, for concealment, it can be bent toward the body. A semirigid device with a central series of segments held together by a spring on either end is a positionable penile implant.

  • Inflatable: A fluid-filled reservoir implanted beneath the abdominal wall, a pump and a release valve within the scrotum, and two inflating cylinders inside the penis are all used in three-piece inflatable implants. Pump the fluid, which is saltwater, from the reservoir into the cylinders to generate an erection.

Treatment with prescription drugs

There are a variety of prescription medications that can be used to treat erectile dysfunction. The drugs include:

Tadalafil. This is a phosphodiesterase type 5 (PDE5) inhibitor. It is used to treat mild to moderate ED. It is usually taken at the same time each day.

Phentolamine. This is an alpha-adrenergic blocker. It is used to treat mild to moderate ED. It is usually taken at the same time each day.

Sildenafil. This is a PDE5 inhibitor. It is used to treat mild to moderate ED. It is usually taken at the same time each day.

The drug most commonly used to treat ED is sildenafil. It is the most effective drug on the market.

There are also some OTC (Over the counter) drug therapy choices. However, the claims made by many of the OTC options have not been evaluated by the FDA and are not endorsed by the Urology Care Foundation, and have limited results with peer-reviewed studies. However, some of these remedies include:

  • DHEA Some studies show DHEA supplements, which help produce sex hormones like testosterone and estrogen, may aid with ED, but others have found no effect.

  • L-arginine is an amino acid (protein building block) present in foods. It increases nitric oxide production, which helps widen blood arteries. Theoretically, expanding blood veins should enhance blood flow to the penis; however, research results are inconsistent. Some firms still misrepresent their efficacy. L-arginine, also known as Hombron, should never be used with Viagra since it might induce a dangerous reduction in blood pressure. Studies on its safety and efficacy are needed.

  • Yohimbine The NCCIH does not recommend yohimbine as an ED therapy. Yohimbine can cause heart attacks and convulsions.

  • Ginkgo biloba may boost sexual desire and reduce ED by increasing blood flow to the penis. The NCCIH claims there is no proof that ginkgo is useful for any health condition. Ginkgo may also induce headaches, dizziness, stomach trouble, palpitations, and constipation. Ginkgo is contraindicated with Coumadin (warfarin) or if you have a bleeding issue.

  • Ginseng may help relax the body's smooth muscles and improve blood flows, resulting in an erection, but its main negative effect is sleeplessness, which raises ED risk. More study is needed to determine its overall efficacy.

  • Epimedium grandiflorum, also known as hairy goat weed, barrenwort, and bishop's hat, is a traditional fertility cure. However, its use for ED is unproven.

Other treatments

There are several other treatments for erectile dysfunction, particularly with a mental health professional. Depending on your primary care doctor's recommendation, they can help you address mental health issues or prescribe prescription medications.

What can cause erectile dysfunction?

On the whole, men are most likely to suffer from the condition in their 40s. Several related health conditions can lead to ED in older men, such as heart disease, hormonal systems changes, mental illness, general health problems, and other more simple issues such as high blood pressure. If you are one of them, you may be thinking about managing to keep a penis firm. 

Here are some of the most common causes of erectile dysfunction:

Psychological

Low self-esteem, stress, depression, and other mental health conditions can contribute to erectile dysfunction. If you feel you have a mental health condition causing ED symptoms to seek a mental health professional.

Psychological causes: 

A. Performance Anxiety 

B. Depression 

C. Stress 

D. Relationship problems 

E. Lifestyle changes

Physical

Hormonal changes, which are often caused by changes in your weight, can also contribute to erectile dysfunction. 

  • Diabetes¬†

  • Hypertension¬†

  • Cardiovascular disease¬†

  • Kidney disease¬†

  • Infertility¬†¬†

  • Spinal cord injury¬†¬†

  • Pelvic injury¬†¬†

  • Peyronie‚Äôs disease¬†

Infection

 Certain types of infection can cause an erection to go away.

When to see a doctor for a physical exam

You should see a doctor if you are having difficulty getting an erection. You may have erectile dysfunction and an underlying condition that needs to be treated, such as high blood pressure. Your doctor will ask you about your symptoms, risk factors, and medical history. They will also perform a physical examination. This will help your doctor to identify the cause of your problem. Your doctor will recommend the treatment that is best for you.

If you have any of the following symptoms, you should see your doctor: 

  • It‚Äôs painful to have an erection.¬†

  • It‚Äôs painful to have an erection that lasts for a long time.¬†

  • You are unable to achieve an erection.¬†

  • You have an erection that lasts for a long time, but it‚Äôs painful.¬†

  • You have an erection that lasts for too long, but it‚Äôs not painful.¬†

  • A burning feeling when you get an erection.

FAQ's

How can I improve my erection?

One of the simplest ways to improve an erection is maintaining overall fitness. Stay hydrated, get plenty of sleep, exercise, and maintain a healthy diet. Not only do these things help improve your sexual performance, but many of the problems that affect erectile function can be prevented with a healthy lifestyle.

How can I get a harder erection?

One of the key things you can do to improve erectile function is to improve your heart health. As we mentioned above, diet and exercise are always helpful. Blood flow is crucial to a firm erection. If you drink a lot of alcohol, are a smoker or eat a lot of fatty foods, these are all things that prevent a harder erection. If all else fails, look to medication or even a cock ring, which can also help prevent venous leakage, a kind of erectile dysfunction in which blood gets to the penis but struggles to stay there.

What is the cause of erectile dysfunction?

There are many causes of erectile dysfunction. If you have read through this article and are unsure what may be the cause, you should seek advice from a medical professional.

How can medical history affect erectile dysfunction?

Several issues relating to your medical history can affect ED. Things such as Cardiovascular disease, hypertension, hypogonadism, lower urinary tract symptoms, diabetes mellitus (DM), cigarette use, hyperlipidemia, metabolic syndrome, and depression are all risk factors for ED. Addressing modifiable risk factors improves a patient's overall health and lengthens your life.

What questions should I ask my doctor about ED?

  • What do you believe is the source of my erection problems?

  • What tests do I require?

  • Is there anything I should avoid eating, taking, or doing? Can I alter my lifestyle to avoid ED?

  • Do you believe I should visit a specialist? How much would that set you back? Will my insurance cover a visit to a specialist?

  • Do you believe my ED will be transient or long-term?

  • What do you think I should do about my ED?

  • What are further treatment options available if one or more treatments fail?

  • Do you have any pamphlets or online recommendations to learn more about ED?

Is it normal to have ED?

Erectile dysfunction is a prevalent illness that affects men of all ages. While having trouble getting an erection from time to time is natural, if it becomes more common or begins to interfere with your sexual life, you should consult your doctor. However, while ED is not a life-threatening problem, it might indicate a more severe medical issue.

How does stress affect ED?

Stress and worry can interfere with how your brain sends information to the penis to flow more blood during an erection. Stress and concern over ED might also lead to a continuing ED cycle. Experiencing ED might result in behavioral changes contributing to anxiety and ED occurrence.