Erectile Dysfunction

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Treatment for erectile dysfunction?

Erectile dysfunction can be successfully treated in virtually all patients, and treatment should be carefully chosen according to the underlying cause of erectile dysfunction and to patients’ preferences and comorbidities.

A variety of medications are now available for patients suffering from erectile dysfunction. Some medications are taken orally whitle others are injected directly into the penis with a very small needle while other are inserted into the urethra at the tip of the penis or robbed on the glans penis.

Alternatively, patients may find beneficial the use of the Vacuum Constriction Device to achieve the rigidity necessary for intercourse.

When medical treatment is ineffective and contraindicated or when the patient does not like or tolerate it, the implantation of a semi rigid or a hydraulic penile prosthesis guarantees the rigidity required for penetrative intercourse.


Which oral medications are available in patients with erectile dysfunction?


The most common oral medications prescribed in patients with erectile dysfunction help to enhance erections and therefore do not trigger automatic erections as injections instead do. Therefore sexual stimulation is necessary for these medications to work.

The most common side effects of these medications are headache, facial blushing, upset stomach and mild temporal visual effects.
In most cases the side effects are minor and tend to reduce with time. Therefore only very few patients decide to discontinue the treatment due to side effects.


Who is the best candidate for injections, and intraurethral medications?


Intracavernosal injections are offered to these patients who do not respond to oral medications, which represent the first line treatment of erectile dysfunction, or when oral medications are contraindicated because of other medical conditions of the patient.

Intracavernosal injection therapy allows the induction of a firm erection even in the absence of sexual stimulation. 

The main advantage of intracavernosal injections is that it represents a very simple solution that can be easily self-administered on demand. 

When performed correctly, intracavernosal injections are a very safe option. The main risk associated with this treatment option is to induce a prolonged erection; this is more likely to happen when an excessive dose of the medication has been injected and needs to be treated as an emergency to avoid permanent damage to the corpora of the penis.

The main reasons why patients stop using intracavernosal injections are inadequate response, fear of needles, desire for a permanent treatment alternative, pain and concerns over side effects. If patients are complaining of pain in the corpora following injections.


Who is a good candidate for the vacuum pump?


The vacuum pump is a tube, which is sealed around the flaccid penis. With the creation of a negative pressure, blood is rushed into the chambers of the penis. Once the desired rigidity is achieved, a constricting ring is applied to the base of the penis to prevent the blood from rushing out of the penis and the vacuum pump is then removed. The vacuum pump can be a viable solution for patients who do not respond or are not suitable for oral and injectable medications and are not keen on penile prosthesis implantation.

Why Choose Giulio

Giulio is a veteran surgeon with 15 years of experience in the field of Andrology and Reconstruction. He is also one of the largest penile prosthesis implanters in Europe, as well as the surgeon who performs the largest number of procedures for the correction of complex cases of Peyronie's disease. He has been invited to lecture and perform surgery in 21 different countries, in 6 different continents.


Penile prosthesis implants last year


Complex Andrological procedures every year


Phalloplasties over his career