Erectile Dysfunction Clinic Patient Information best

Erectile Dysfunction Clinic
Patient Information
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What is erectile dysfunction?
Erectile Dysfunction (ED) is the persistent inability to get or maintain
an erection that is sufficient for successful sexual intercourse.
How common is ED?
ED effects approximately half of all men between the ages of 40-70.
What causes ED?
ED can have many causes that are either physical (within the
body) or psychological (related to mind).
Common causes are:
• high cholesterol
• diabetes
• some medications
• hormonal problems
• blockage of blood supply to penis
• venous leakage of blood away from penis
• Peyronnies disease
Psychological causes may include anxiety, depression,
relationship problems, and stress.
Your healthcare practitioner will discuss with you your individual
case and what may be contributing towards your ED.
Is there a cure for ED?
ED can have a significant impact on your quality of life and
currently there is no known cure for ED. However there are
treatments available, which may be able to provide you with a
good quality erection to have satisfactory sexual intercourse.
What can I expect to happen at clinic?
The healthcare practitioner will ask you some questions to assess
your erections.
Blood tests will be taken and you will be given a physical
The healthcare practitioner will discuss treatment options, and in
some cases shown to you, in clinic.
Can I refuse any part of the assessment?
Of course you may refuse to have any part of the assessment
carried out. The healthcare practitioner may not be able to assess
your symptoms fully or recommend the most beneficial treatment
to you, without being able to gain all of the information.
What are the treatment options?
The symptoms of ED may be helped by making lifestyle changes
which can reduce risk factors which make you more at risk from
getting ED.
These include:
• Losing weight
• Reducing alcohol intake
• Not taking illegal drugs
• Giving up smoking
• Exercising regularly
These changes may also have an impact on improving your
general health.
Your treatment options will depend on the findings of the
healthcare practitioner. If your ED is caused by an underlying
medical condition, it may be necessary to treat the condition
first, before treating the ED.
If a hormonal problem is identified, it may be necessary to refer
you to an endocrinologist. An endocrinologist is a specialist in
the treatment of hormonal conditions.
There are 4 different treatments available for erectile
• Tablets taken prior to intercourse (VIAGRA, CIALIS and
• A pellet of medication that goes into your urethra (water pipe)
called MUSE (medicated urethral system for erection)
• Injections that go directly into the penis called CAVERJECT
• Vacuum suction devices - an external plastic tube placed over
the penis. When activated it creates a vacuum that allows
the penis to fill with blood. To keep the penis erect a rubber
constriction band is placed on the penis during intercourse
• Psychological therapy (counselling)
Medication for ED
Viagra – This is available in different strengths, and your
healthcare practitioner will discuss this with you. Viagra needs
to be taken at least 30 to 60 minutes prior to sexual intercourse,
and lasts for around 8 hours.
Cialis – This is available in different strengths, which can change
how you take this medication. One type of Cialis is taken in
the same way as Viagra, at least 30 minutes prior to sexual
intercourse, but each tablet may be effective for a maximum of
36 hours. Another type of Cialis is taken on a daily basis.
Levitra – This is available in different strengths and also needs
to be taken at least 30 minutes prior to sexual intercourse.
Manufacturer recommendations are that it lasts around 8 hours.
These tablets work through sexual stimulation and therefore you
need to be aroused in order for them to become effective. The
type of tablet that may be best suited to individual need, will be
discussed by your healthcare practitioner at your appointment.
Side effects from tablets may affect some people and not
others. How you will be affected is unknown until you have
tried the tablets. Below is a list of the most reported side
effects in our clinics:
• flushing (redness)
• indigestion
• nausea (feeling sick)
• vomiting (being sick)
• a blocked or runny nose
• back pain
• vision disturbances
• muscle pain
• headaches and migraines
The active drug in MUSE and CAVERJECT is Alprostadil. This is a
man-made hormone which stimulates blood flow to the penis.
You will be taught how to use these treatments at your
appointment, by your healthcare practitioner, and it may take
between 1 and 8 weeks, to establish you on a dose which is
effective. Alprostadil will usually produce an erection within 15
minutes and how long it lasts can vary from patient to patient.
The side effects of Alprostidil again vary depending on the route
of administration but include:
• changes in your blood pressure
• dizziness
• headache
• pain in your penis
• urethral burning or bleeding
• reactions at the site of the injection, such as swelling
• dizziness and sometimes fainting
MUSE – is a pellet of medication that goes into your urethra
(water pipe).
CAVERJECT – is an injection that goes directly into the penis.
Both of these treatments need to be tried within the clinic
setting and cannot be prescribed by your GP until the dose of
medication has been determined and your technique in using
these treatments has been assessed as being safe.
Vacuum suction devices
If a vacuum suction device is appropriate for you, your healthcare
practitioner will arrange a further appointment for you with the
product specialist. They will show you how these devices work.
You can try a device to see what effect you get before deciding
to order one. These devices can cost around £150, therefore we
want you to be completely happy with the outcome prior to
purchase (if you are entitled to a prescription on the NHS then
these pumps are prescribed by your GP and you would only pay
the prescription charge, if this applies to you).
Do I have to pay for ED treatments?
The Department of Health guidelines state that unless patients
have one of the following conditions, then they must pay for
their ED treatments. Your GP and healthcare practitioner cannot
change these national guidelines.
• Diabetes
• Multiple sclerosis
• Parkinson’s disease
• Poliomyelitis
• Prostate cancer
• Prostatectomy
• Radical pelvic surgery
• Renal failure treated by dialysis or transplant
• Severe pelvic injury
• Single gene neurological disease
• Spinal cord injury
• Spina bifida
• Patients who were taking treatments for ED prior to 14
September 1998
Once you are happy with a treatment option, your healthcare
practitioner will write to your GP asking him to provide you
with a prescription. If you do not meet the requirements to
receive free prescriptions, this prescription is commonly known
as a ‘Private Prescription’. When you take this to a pharmacy,
they will know that you are required to pay the full cost of the
prescription. If you do meet the requirements then you will
receive a prescription in the usual manner.
How much will I have to pay for treatments?
Each treatment will have a different cost and will also change
over time. The current average costs will be discussed with you,
by your healthcare practitioner.
For further information please contact:
Advanced Nurse Practitioner
Michele Miletic
Telephone: 0121 672 7843
Urology Clinical Nurse Specialist
Kelly Calame
Telephone: 0121 627 2284
Mr Subramonian Secretary
Telephone: 0121 371 5737
The Trust provides free monthly health talks on a
variety of medical conditions and treatments. For more
information visit or
call 0121 371 4957.
Queen Elizabeth Hospital Birmingham
Mindelsohn Way, Edgbaston,
Birmingham, B15 2WB
Telephone: 0121 627 2277
PI11_1247_01 UHB/PI/1247 (Edition 1)
Author: Kelly Calame Date: August 2012 Review date: August 2014