Erectile Dysfunction (Impotence)

As men get older it may become more difficult for them to achieve and/or maintain an erection. The anxiety created by this may be further exacerbated following cancer treatment. Damage to the erectile nerves during surgery or following radiation therapy may cause a temporary or permanent loss of erectile function.

If you do experience problems achieving or maintaining an erection, there are a number of treatments that can help you. Also, erectile dysfunction could potentially be an early tell-tale sign of underlying cardiovascular risk factors and diseases.

Tablets such as Viagra®, Levitra®, and Cialis® are available and can increase blood flow to the penis, thus achieving an erection. Common side effects of these tablets include headaches and hot flashes. Men with a history of cardiovascular problems or taking anti-angina medication should consult their doctor prior to taking these tablets, as this method of treatment may not be appropriate.

Another popular form of treatment is penile injection. This involves injecting a substance into the base of the penis that dilates the blood vessels enabling them to fill with blood and thus creating an erection. This method is successful for most men but is essential for your doctor to work out an accurate dosage for you to prevent your erection from lasting too long. A penile vacuum pump with the aid of a penile constrictor ring can also assist in penile erection but can be cumbersome to apply and the long-term risk of venous stasis on penile smooth muscle function is questionable.

The penile prosthesis can provide men with an artificial erection and is usually the last option for men to remain sexually intimate and achieve sexual intercourse. A penile prosthesis is implanted into the penis under general anesthetic, and can only be revised or removed through another operation. There are two main types of penile prostheses, the Semi-Rigid implant, and the Inflatable implant. Most men prefer an inflatable 3-piece penile prosthesis device as it closely simulates a normal erect penis. Inflatable implants involve the insertion of two cylinders into the penis and a reservoir of 60-100mls of saline deep behind the pubic bone. A pump and valve are inserted into the scrotum allowing the saline to be pumped into the penis, thus producing an erection. When an erection is no longer needed the valve can be released allowing the saline to drain back into the reservoir and the penis to become flaccid (soft). Without a doubt, a penile prosthesis implant is the most effective therapy to give a man an erect penis whenever he wants and for as long as he wants his erection to last.

Prof. Chung is the leading author of the clinical guideline in management of erectile dysfunction that is endorsed by the Urological Society of Australia and New Zealand (USANZ) and the Australasian Chapter of Sexual Health Medicine (AChSHM) for the Royal Australasian College of Physicians (RACP) - Chung E, Lowy M, Gillman M, Love C, Katz D, Neilson G. Urological Society of Australia and New Zealand (USANZ) and the Australasian Chapter of Sexual Health Medicine (AChSHM) for the Royal Australasian College of Physicians (RACP) clinical guidelines on the management of erectile dysfunction. Med J Aust. 2022;217(6):318-324

As with all surgical procedures, there are risks associated with the anesthetic, surgery, and implant device that your urologist will discuss with you. Prof. Chung has the largest volume of publications on penile prosthesis implant surgery and is recognized as a leading international surgeon expert in this field. He offers all 3 types of inflatable penile prosthesis implants- Boston Scientific AMS 700 series, Coloplast Titan series, and Rigicon Infla10 devices.

Prof. Chung is the leading author of the International Penile Prosthesis Implant Forum on the consensus statement and evidence-based surgical recommendations for the inflatable penile prosthesis implantation - Chung E, Bettocchi C, Egydio P, Love C, Osmonov D, Park S et al. The International Penile Prosthesis Implant Consensus Forum: Clinical recommendations and surgical principles on the inflatable 3-piece penile prosthesis implant. Nat Rev Urol. 2022;19(9):534-546

It is essential that, if you are experiencing problems associated with erectile dysfunction, you discuss this with your family doctor or urologist.