Erectile Dysfunction (ED) is the persistent inability to achieve or maintain an erection firm enough for sexual intercourse. It can affect men of any age and impacts quality of life, confidence, and relationships — but modern treatments make ED highly manageable.
What Is Erectile Dysfunction?
Common Causes of ED
- Vascular disease (atherosclerosis, limited penile blood flow)
- Diabetes (nerve and vessel damage)
- Hypertension
- Low testosterone (low libido, poor erection quality)
- Neurologic conditions (spinal injury, MS, neuropathy)
- Pelvic surgery/trauma (e.g., after prostate surgery)
- Psychological factors (stress, anxiety, depression)
- Medications (some BP meds, antidepressants, prostate meds)
- Lifestyle (smoking, obesity, inactivity, excess alcohol)
Our Comprehensive Evaluation
- Detailed medical & sexual history
- Focused physical exam (vascular, neurologic, hormonal)
- Blood work (including testosterone and relevant labs)
- Optional penile Doppler testing for vascular assessment
Treatment Options
Oral Medications
First-line PDE5 inhibitors — sildenafil (Viagra®), tadalafil (Cialis®), vardenafil (Levitra®), avanafil (Stendra®) — improve penile blood flow in response to sexual stimulation. Tadalafil can be taken as needed or daily.
Safety: These pills must never be combined with nitrates (such as nitroglycerin) or certain other heart medications — the combination can cause a dangerous drop in blood pressure. Common side effects include headache, facial flushing, and a stuffy nose. Seek help right away for any sudden change in vision or hearing after taking an ED medication.
Intracavernosal Injections (Trimix)
For men who don’t respond to pills. A small self-injection produces a firm erection in minutes, typically lasting 30–60 minutes. Highly effective even in severe ED. We provide hands-on, in-office training so you can inject safely and confidently.
Inflatable Penile Prosthesis (IPP)
Our surgeons are among the highest-volume IPP implanters in the country. The device is completely internal, produces a natural-feeling erection on demand, and boasts high satisfaction for patients and partners. Ideal when pills/injections fail or aren’t tolerated. Learn more about penile implants.
Low-Intensity Shockwave Therapy (LISWT)
Non-invasive acoustic waves stimulate new blood vessel growth and may improve natural erections and response to medications. No downtime; delivered in clinic-based sessions. Learn more about LISWT.
Vacuum Erection Device (VED)
A non-surgical, drug-free pump draws blood into the penis to create an erection, held in place with a constriction ring. A safe option for men who can’t use or don’t respond to pills, and valuable for recovery after prostate surgery. We provide in-office training for safe use. Learn more about the VED.
Hormone Optimization (Low T)
Testosterone deficiency can worsen ED, libido, energy, and mood. We evaluate and treat when appropriate, often combining with other ED therapies for optimal results. Learn more about low testosterone.
Stepwise approach: We start with the least invasive options and progress only as needed — always aligned with your goals, medical history, and partner considerations.
Heart Health & Sexual Activity
Sexual activity can strain the heart in men with serious cardiac disease. Call your doctor — or seek emergency care — if you have chest pain, shortness of breath, or dizziness during sex. Tell us about your heart history and every medication you take so we can choose the safest ED therapy for you.
Why Choose Advanced Urology
Experience & Outcomes
High-volume ED specialists with deep expertise across medical, procedural, and surgical therapies — including one of the nation’s leading IPP programs.
All Care Under One Roof
From evaluation and labs to advanced therapies and surgery, we streamline your care for convenience and consistency.
Discreet, Patient-Centered Care
Private, supportive environment; clear communication; and shared decision-making to restore sexual health and confidence.
Take the Next Step
If ED is affecting your life, we’ll identify causes, review every option, and create a personalized plan — from lifestyle and medications to injections, LISWT, hormone therapy, or IPP with our expert, high-volume implant team.
Medication risks/benefits are reviewed individually. Do not start/stop therapies without medical guidance.