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Erectile Dysfunction

What is Erectile Dysfunction?

According to the National Institute for Health (NIH) Erectile dysfunction (ED) is a condition in which you are unable to get or keep an erection firm enough for satisfactory sexual intercourse. ED can be a short-term or long-term problem. You have ED when you

· can get an erection sometimes, but not every time you want to have sex

· can get an erection, but it does not last long enough for fulfilling or satisfactory sex

· are unable to get an erection at any time


  

What Causes Erectile Dysfunction?

Erectile dysfunction can be the result of several factors and an individual can be suffering with multiple conditions. Potential causes include:

· Stress

· Anxiety

· Injuries

· Smoking

· Diabetes

· Drug use

· Alcohol use

· Cardiovascular disease

· Relationship problems

· Damage from cancer or surgery

What Treatments Are Available?

Treatment for ED will be contingent on what is causing the issue. When the issue is connected to a pre-existing medical condition, treating the issue can assist to eliminate ED. ED is commonly connected to the man’s lifestyle. Changes that improve the man’s overall health can help to treat erectile dysfunction. These changes can be as simple as losing excess weight, stopping the use of drugs, alcohol, and cigarettes, and increasing exercise and activity.

The management algorithm at Exclusive Care Wellness Spa proceeds in a stepwise manner in order to ensure comprehensive, state-of-the-art treatment in the management of erectile dysfunction (ED). This begins with evaluation and first line therapy including confirming associated medical conditions are managed and psychological support combined with oral medical therapy and or shockwave therapy. Shockwave therapy may be combined with other options. Second line therapy includes recommendations of vacuum erection device therapy,  and penile injection therapy. Third line therapy usually involves surgery with implantation of a penile prosthesis.


SO WHAT ARE MY OPTIONS?


Oral Agents (Pills)

Avanafil (Stendra), Sildenafil (Viagra), Tadalafil (Cialis) and Vardenafil (Levitra, Staxyn) are called inhibitors of phosphodiesterase type 5 (PDE5-I) and they all work by the same mechanism. Viagra® was the first oral agent with proven benefit in the treatment of erectile dysfunction. Currently, there are several oral products which differ in time needed to achieve erection, effects of food intake on activity, and daily or on-demand use. This gives providers and patients more flexibility in choosing the best type of medication to suit individual needs.

The advantage of medications in this group is their simplicity of use. Medications in this group help promote the development and maintenance of an erection. Stimulation is required for these medications to work. It is important to note that these medications do not affect sex drive or libido. Treatment with any of these PDE5 inhibitors allows approximately 65% of men to resume sexual intercourse. Headache, flushing, transient visual disturbances, back pain, and dyspepsia are the most common side effects.


Shockwave Therapy

Low-intensity extracorporeal shock wave therapy (LI-ESWT) is a novel modality that has recently been developed for treating erectile dysfunction (ED). Unlike other current treatment options for ED, all of which are palliative in nature, LI-ESWT is unique in that it aims to restore the erectile mechanism in order to enable natural or spontaneous erections. Results from basic science experiments have provided evidence that LI-ESWT induces cellular microtrauma, which in turn stimulates the release of angiogenic factors and the subsequent neovascularization of the treated tissue. Extracorporeal shock wave therapy (ESWT) has been clinically investigated and applied in several medical fields with various degrees of success. The results of the studies, which also included a double-blind randomized control trial, confirm that LI-ESWT generates a significant clinical improvement of erectile function and a significant improvement in penile hemodynamics without any adverse effects.  


Penis Rejuvenation with Shockwave Therapy


Penis rejuvenation with shockwave therapy can help you improve your natural erection but also assist with the healing process after a  penis enlargement surgery, potentially leading to a better aesthetic outcome.  We recommend carrying out a maximum of 3 sessions, 2 weeks before your penis enlargement surgery.  Each session last 20 minutes, the treatment itself is very comfortable and non-invasive.


Vacuum Erection Device

Vacuum erection devices, also known as vacuum constriction devices, have been utilized for improving erectile rigidity for over a century. Bruising, skin breakdown, and penile pain associated with the application of the constriction band are among possible side effects.


Penile Injections (Tri-mix) 

Injection therapy represents a cornerstone of ED therapy and remains the gold standard for medical therapy. To date, a number of medications have been used for this purpose, most commonly papaverine, phentolamine, and alprostadil. These medications have been administered in a variety of combinations with good effect. The success rate, defined by the production of an erection rigid enough for intercourse, has been in excess of 75%. Disadvantages include the more complex route of administration (injection into penis), potential for bleeding, bruising, penile fibrosis, and a higher incidence of priapism (notwithstanding all uncommon side effects).


Penile Implant (Prosthesis) Surgery

Penile Implant (prosthesis) Surgery represents a safe and effective means of treating men with ED. Penile prosthesis has the highest satisfaction rates of all treatment options for erectile dysfunction. Patients who attempt, but dislike or fail to achieve, satisfactory results with pills, vacuum devices, or injections, are counseled about penile implant surgery.

Penile prostheses can be divided into two main categories: malleable (also known as non-hydraulic or semi-rigid) and inflatable (hydraulic). 

Prior to surgery, it is important that all patients receive appropriate education concerning the operative procedure and its associated risks and benefits. We also insist on all patients reading device literature and viewing a device video prior to committing to the procedure. Ensuring that the patient has realistic expectations prior to proceeding with implant surgery is essential to ensuring high postoperative satisfaction profiles. Patients are advised that the prosthesis will allow them to achieve a rigid erection on demand and will have no effect on their libido and will not lengthen their penis. Patients are also informed of infection rates (1-3%) and rates of re-operation second to device malfunction (15% within 8 years).

Penile implants offer the patient a very high level of satisfaction with spontaneity, consistency, and rigidity.  If you are interested please contact us for a consultation.


Combination Therapy


VitalityRED® (XoLife, LI-ESWT & Platelet-Rich Fibrin Matrix) is a treatment that is restorative. This means it restores normal function and improves blood flow to the penis so men can achieve and maintain sexual erection spontaneously and naturally. Using a combination of advanced shockwave along with restorative therapy, we can stimulate the body’s natural healing response and help restore healthy blood flow and erection performance. This revolutionary protocol is administered over a six-treatment process that can be successfully done in 2-3 weeks.


XoLife® (Exosomes): Exosomes are MSC-derived, extracellular secretions that carry significant amounts of growth factors and proteins which contribute to their healing properties. Exosomes enhance and work in synergy with recruited stem cells to upregulate angiogenesis in the penile region when combined with our innovative therapy system.


Low-intensity extracorporeal shock wave therapy (LI-ESWT): Radial shockwave therapy is a non-surgical technique that utilizes a unique set of proprietary acoustic pressure waves that are delivered through the body and focused on the site of pain and injury. This results in microscopic tears to the tissue that enhance blood-circulation and promote healing to the penile region.


PRFM® (Platelet-Rich Fibrin Matrix): is a next generation platelet therapy with a more advanced preparation of PRP that does not involve contamination of RBC’s or WBC’s. This fibrin rich matrix goes through a controlled process that eliminates almost all contamination leaving a pure platelet solution free of radicals and rich in gold color.

Learn More

 VitalityRED (Regenerative  Erectile Dysfunction) is a total package that combines advanced  Regenerative technology to improve erectile dysfunction without the use  of pills. This revolutionary treatment uses a non-surgical technique  combined with natural catalysts to stimulate the body’s healing response  and to restore healthy blood flow as well as performance. Provider  training is provided at our Center of Excellence as part of this  program.