“Erectile dysfunction is a very common problem,” says Matthew Sand, M.D., a urologist at Piedmont Atlanta Hospital. “I think it’s under-diagnosed and undertreated in America. Approximately one-third of men in middle age experience erectile dysfunction on a fairly regular basis.”

The most common cause of erectile dysfunction is cardiovascular disease.

“The same things that cause heart attack and stroke cause erectile dysfunction,” he says. “In fact, many men present with erectile dysfunction before they have their cardiovascular event. It’s important to see a doctor as soon as you’re experiencing these problems.”

Treatment Options

“Generally, the first line of treatment is oral medications,” Dr. Sand says. “There are prescription medications that have been around for over 10 years now that are well-proven to be effective. Generally, your primary care doctor will be prescribing those medications for you.”

If oral medications do not improve symptoms, Dr. Sand recommends visiting a urologist who can provide additional treatment.

“There are some treatments I use prior to recommending surgery,” he says.

These treatments include injection therapy and suppositories into the urethra. If these methods are not effective, surgery may be the best option.

Surgical Treatment

“The main surgical therapy is the penile prosthesis implantation,” he explains. “There are two types of prostheses. There is a two-piece, or malleable, prosthesis which has two bars implanted into the penis that you can bend up or down. There is also a three-piece, or inflatable, prosthesis that has two cylinders in the penis, a pump in the scrotum and a reservoir balloon in the abdomen.” These devices are not visible and “they function very well to provide a very natural-appearing erection with normal sensations and normal ejaculatory function.”

The operation can be done as an outpatient procedure and typically takes 1.5 hours, although occasionally, Dr. Sand will have his patients stay in the hospital overnight for observation. “You can expect approximately two weeks of being fairly sore and should be able to return to sexual intercourse in about four weeks,” he says. “The advantage of a prosthesis is that it’s portable, you don’t have to remember to refill anything or travel with anything, and it allows for the spontaneity of sex because you can always initiate an erection.”

Seeing a specialist is advantageous because he or she can provide the full spectrum of diagnosis and treatment, from the oral medication stage to injections to surgery. “You’ll have the same team of doctors and nurses, and the same team in the hospital,” says Dr. Sand. “We’ll always be around to support you.” To find a physician near you, visit Piedmont Physicians Group.

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