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Injection therapy for erectile dysfunction

A urologist may recommend a medication that is delivered directly to the penis through injection therapy. The doses can be increased, as needed, by your doctor.

Injection therapy is FDA-approved for erectile dysfunction. The man injects a prescription medication (alprostadil or papaverine) into the side of the penis (where, Dr. Honig says, there isn’t a significant pain response). The medication helps increase blood flow to the penis. “If you can tolerate a flu shot, you can tolerate this,” he says.

Another way medication can be delivered locally is through a suppository or intraurethral agent. The man (or his partner) inserts the thin applicator a centimeter into the urethra and injects a pellet-sized bead of alprostadil. The medication dissolves and dilates blood vessels in the penis.

How long until it takes effect? 5 to 15 minutes

How long does an erection last? 60 minutes

Vacuum devices for erectile dysfunction

A vacuum device does not involve medication. It is, however, more cumbersome and less discrete. The device costs between $200 and $400. A man or his partner places it over his flaccid penis. It creates negative pressure to draw blood into the penis to create an erection, explains Dr. Honig. A ring then needs to be placed at the base of the penis to keep blood within the erectile bodies; once removed, the erection will subside.

How long until it takes effect? 5 minutes

How long does an erection last? An erection may last more than an hour; however, to minimize the risk of penile injury, the ring should be removed within one hour.

Penile implant surgery for erectile dysfunction

When other methods are not working, your urologist may suggest a penile implant, which is an outpatient procedure—you can go home the same day. According to Dr. Honig, because this option can restore spontaneity and is reliable in most cases, the patient satisfaction rate is high.

“The goal of the operation is to give you a functioning penis, so you can have penetrative sex,” says Dr. Foster.

As with any surgery, there are risks such as the chance of infection, but there is another factor men need to consider. “Implants are a one-way street,” says Dr. Foster. “When you put an implant in, you can’t take it out and try the injections or suppositories.”

During the surgery, which takes about an hour, the doctor makes an incision in the scrotum, or base of the penis, and measures the appropriate implant length.

The urologist then installs the device (usually an inflatable implant) that sits inside the scrotum, plus a reservoir that holds the fluid (salt water solution) in the lower abdomen. The fluid functions like blood flow, filling the erectile bodies. The man controls it with a pump that’s placed in the scrotum (a button causes the fluid to flow in and out as desired).

How long until it takes effect? Following surgery, men can resume sexual activity within six weeks.

How long does an erection last? There are no time limits. “Once they pump it up, it stays up,” says Dr. Foster.

In the end, which—if any— erectile dysfunction solution you choose depends on the right method for you.

“If sexual activity is important to you, see a doctor if you’re experiencing problems with erections—no matter what age you are or what your health condition is,” says Dr. Foster.

“We have a treatment for everyone; it just depends on what you want to do to fix the problem,” says Dr. Honig.

Click here for more information about the Yale Medicine Urology Male Sexual Medicine Program. Or, to make an appointment, call 203-785-2815.