Penile Injections for ED – Are They Extreme?

Discussing the full range of treatment options for exile dysfunction or ED is good practice. For most patients, five treatment options exist:

• Medication such as Viagra/sildenafil and Cialis/Tadalafil
• Urethral suppositories
• Vacuum erection devices
• Penile injections
• And penile prosthesis or implants.

Regarding ED, Dr. Engel feels strongly that a stepwise approach toward treatment is best for virtually every patient. For many, especially those with mild to modern erectile dysfunction, medications can be an excellent option for years after their diagnosis. However, urethral suppositories and vacuum erection devices are somewhat less effective and may reduce the pleasure associated with sexual intercourse either for the patient, the partner, or both.

As a result, Dr. Engel’s patients are given the option of penile injections after medication is no longer working. If you cringed just a little, we wouldn’t blame you. After all, the idea of injecting the penis sounds extreme. But is it? The short answer is no, and while Dr. Engel will undoubtedly entertain the possibility of a penile implant even if a patient has not tried injections, there’s good reason to try injections before going that route.

• First, Dr. Engel is a big proponent of education regarding injections. Not only do we discuss how the injections work, and they work very well, but we also take great pains to show each patient how to best inject the penis to reduce any pain and make it virtually second nature before a sexual encounter.
• Second, while there are concerns regarding priapism or the dreaded four-hour erection due to injections, Dr. Engel explains proper dosing and, as such, takes steps to minimize the occurrence of this risk in his practice.
• Lastly, why opt for anything more invasive and permanent, like a penile implant, if you haven’t tried all the less invasive options? Penile injections may not be suitable for patients with prolific sex lives, but this can be discussed with Dr. Engel at a consultation.

Consequently, most patients understood the value and benefits of these injections and proceeded with them, finding that they were less disruptive than believed.

Other Options

Of course, even penile injections may lose effectiveness over time, or patients may have ED severe enough that injections do not work in the first place. For these patients, there’s always an option for a penile implant. There are several types of penile implant, but Dr. Engel prefers the three-piece inflatable penile prosthesis, which allows a man to discreetly inflate the device to give the patient a firm erection on demand, then deflate the device when not in use. This is particularly useful for very sexually active patients and patients who have had extensive trauma to the genital region and otherwise would not be able to have regular intercourse.

We try to impress upon our patients that, despite their thoughts on age, an active sex life is an essential part of mental and physical health, even in their later years. Many patients see erectile dysfunction as the end of their intimate lives, but this certainly does not have to be the case.

The next and best step is to visit a qualified urologic surgeon like Dr. Engel, who, after a brief consultation, can help you understand the best options for erectile dysfunction. With that said, for patients who still respond to medication, Dr. Engel offers a discreet online medication ordering option that includes free consultation and free expedited shipping nationwide. The medicines are inexpensive compared to many other options, even online, and patients can rest assured that if medications are no longer working or they need advice, they have us as a resource.