ED Treatment in Brentwood, TN

Due to its sensitive nature, ED is a condition that is not talked about. Men suffering from erectile dysfunction are often unaware of the various treatment options available to them and thus do not seek help. Dr. Howard Aubert is a board-certified urologist and provides surgical and nonsurgical treatment for ED at his urology clinic in Brentwood, TN.

To schedule a consultation for erectile dysfunction treatment, please call (615) 988-8103 or request an appointment through our secure online form.

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What Are the Causes of Erectile Dysfunction?

ED normally stems from two separate categories of physical and mental health issues. Most often, erectile dysfunction is the result of a physical problem. These can include a variety of different situations, but they typically relate to:

Not having enough blood flow to the penis - Conditions like heart disease, diabetes, and hardened arteries can all restrict the functions of an individual’s circulatory system, which can prevent proper amounts of blood flow to certain areas of the body. It may also be difficult for an individual to keep blood in the penis long enough to sustain an erection.
Problems with the nerve endings - Damage to the pelvic region can often lead to damage of the nerves. Injury, cancer treatments, or even a disrupted signal from the brain can all cause these nerves to malfunction and diminish a person’s senses.
Side effects of medication - There is always a risk to taking a medication, but some risks can impact sexual function both temporarily and long-term. Make sure to discuss all possible side effects to a new medication with your healthcare provider.

Other cases of erectile dysfunction may be caused by emotional or psychological issues, such as:

Stress
Depression
Anxiety
Relationship problems
Worry about poor sexual performance

It is certainly possible for both physical and mental factors to contribute toward a single patient’s erectile dysfunction. Many people with ED discover that a physical issue will lead to stress in a relationship or about sexual performance, which can make their erectile dysfunction even more difficult to deal with. This potentially endless circle can be broken by speaking with Dr. Aubert about your erectile dysfunction and what may be causing it to occur.

ED Treatment Options

Erectile dysfunction (ED) is not an inevitable part of aging.¹ There are several treatment options depending on the reason for your ED.² It's important to explore and learn about all alternative treatment options.

Your doctor will be able to explain all your options and help you choose the best option for you. There are many options and suggestions your doctor may give you, such as making lifestyle changes (diet, exercise, better habits), trying medication or a vacuum erection device, or a penile implant.^{2, 3}

Penile Implants

A penile implant offers a long-term solution for ED.⁴ It is an erection assistance device that is placed inside the body during an outpatient implant procedure. It allows for spontaneity and puts the man back in control of his body. Penile implants were designed to mimic the look and performance of a natural erection.⁵

For more information about penile implants, visit the Penile Implants page.

Oral Medication

Pills like Viagra^™, Cialis^™, Levitra^™, or Stendra^™ may help achieve erections in response to stimulation. They generally should be taken at least half an hour to one hour before anticipated sexual activity. Potential side effects include headaches, facial blushing, upset stomach, back pain/muscle aches, and nasal congestion.¹⁰

TM* Third party brands are property of their respective owners.

Penile Injections

A penile injection is placed into the penis to inject medication to create an erection. This produces an erection within 5-20 minutes.⁶ Potential side effects include priapism (erection lasting 4 hours or more), penile pain, numbness or irritation, bruising at the injection site, and penile fibrosis (deformed penis shape).⁷

Vacuum Erection Devices

Vacuum erection devices are external pumps placed over the penis to help with ED. The device, consisting of a cylinder and pump, creates a vacuum that pulls blood into the penis creating an erection and a constriction ring that helps maintain the erection. Patients who use vacuum erection devices may experience penile discomfort, penile numbness, and an erection that is not warm to the touch, among other potential side effects.⁹

Insertable Medication

Insertable medications are another ED solution available but are not as commonly prescribed. A small pellet (suppository) is inserted into the urethra using an applicator and the pellet is released allowing for increased blood flow, creating an erection. Erections usually start within 10 minutes and last between 30-60 minutes. Side effects can include burning and aching in the penis and groin.⁸

Titan^® and Titan^® Touch Inflatable Penile Prosthesis – Important Safety Information

A penile implant, also called a penile prosthesis, is concealed entirely within the body to address erectile dysfunction (impotence). The implant requires some degree of manipulation before and after intercourse to make the penis erect or flaccid.

Indications
The Titan and Titan Touch Inflatable Penile Prosthesis is indicated for male patients suffering from erectile dysfunction (impotence) who are considered to be candidates for implantation of a penile prosthesis.

Contraindications
The Titan and Titan Touch Inflatable Penile Prosthesis is contraindicated in patients who have one or more of the following: (1) Patients with an active infection present anywhere in the body, especially urinary tract or genital infection. (2) Patients with a documented sensitivity to silicone. (3) Patients with unresolved problems affecting urination, such as an elevated residual urine volume secondary to bladder outlet obstruction or neurogenic bladder. (4) Patients unwilling to undergo any further surgery for device revision.

Warnings
Implantation of the device may make latent natural erections, as well as other interventional treatment options, impossible. Men with diabetes or spinal cord injuries, as well as immunocompromised patients, may have an increased risk of infection associated with a prosthesis. Implantation of a penile prosthesis may result in penile shortening, curvature or scarring.

Precautions
Removal of an implanted prosthesis without timely reimplantation of a new prosthesis may complicate subsequent reimplantation or may make it impossible. MRI quality may be compromised if the area of interest is in the exact same area or relatively close to the position of the Titan, and Titan Touch IPP. Be sure to consult with your physician. Patients should discuss all available treatment options and their risks and benefits with their physician. Health conditions which hamper sexual activity, such as severe chest pain (angina), may prevent successful use of this device. The prosthesis should not be implanted in patients who lack the manual dexterity or strength necessary to operate the device. Trauma to the pelvic or abdominal areas, such as impact injuries associated with sports (e.g., bicycle riding), can result in damage of the implanted device and/or surrounding tissues. This damage may result in the malfunction of the device and may necessitate surgical correction, including replacement of the device. The device may be used in the presence of Peyronie’s Disease.

Potential Complications
Penile implants are surgical solutions requiring a healing period that have risks associated with surgery such as scrotal swelling, auto-inflation, discomfort, angulation/curvature, swelling (edema), device malfunction, chronic pain, difficulty with ejaculation, transient urinary retention, fever, migration, patient dissatisfaction, infection at surgical site or wound, deflation, swelling of clotted blood or clear fluid (hematoma/seroma), wound leakage, bleeding, delayed wound healing, narrowing of the opening of the foreskin (phimosis), sensory loss, cylinder malfunction, formation of thick tissue (fibrous capsule formation), over/under inflation, erosion, scrotal reddening (erythema), genital change, and inguinal hernia.

This treatment is prescribed by your physician. Discuss the treatment options with your physician to understand the risks and benefits of the various options to determine if a penile implant is right for you.

Caution: Federal law (USA) restricts this device to sale by or on the order of a physician.

References

Definition & Facts for Erectile Dysfunction. NIH: National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/definition-facts. Accessed March 2023.
Burnett AL, Nehra A, Breau RH, Culkin DJ, Faraday MM, Hakim LS, Heidelbaugh J, Khera M, McVary KT, Miner MM, Nelson CJ, Sadeghi-Nejad H, Seftel AD, Shindel AW. Erectile Dysfunction: AUA Guideline. J Urol. 2018 Sep;200(3):633-641.
Treatment for Erectile Dysfunction. NIH: National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment. Accessed March 2023.
Miller LE, Khera M, Bhattacharyya S, Patel M, Nitschelm K, Burnett AL. Long-Term Survival Rates of Inflatable Penile Prostheses: Systematic Review and Meta-Analysis. Urology. 2022 Aug;166:6-10.
Data on file at Coloplast
MUSE^™ (alprostadil) urethral suppository IFU. Meda Pharmaceuticals, Inc. Revised April 2018.
Yuan J, et al. Vacuum therapy in erectile dysfunction – science and clinical evidence. International Journal of Impotence Research. 2010; 12: 211-219
Cialis.^™ Highlights of Prescribing information. Lily USA, LLC. Revised February 2018.

Schedule an Appointment for Erectile Dysfunction Treatment in Brentwood, TN

Dr. Howard Aubert specializes in providing comprehensive treatment for patients suffering from erectile dysfunction at his urology clinic in Brentwood, TN. To learn about your treatment options, please call (615) 988-8103 or request an appointment through our secure online form.