Surgery

In a few cases, surgery may be an option to treat erection problems (erectile dysfunction). Surgery will rarely be recommended before nonsurgical treatment and counseling have been tried.

Surgery on the pelvic area, such as prostate or bladder surgery, can sometimes damage nerves there and cause erection problems. But this is much less common than it used to be. For example, a surgeon now may do a nerve-sparing radical prostatectomy as treatment for prostate cancer. Some surgeons do nerve grafts as part of surgery for prostate cancer when the nerves cannot be saved. In a nerve graft surgery, the surgeon takes nerves from another part of your body and uses them to replace nerves damaged during surgery.

Surgery Choices

Penile Implants

Surgery on Penile Blood Vessels

What to Think About

Think carefully about nonsurgical options and about the possible risks of surgery. Include your partner in your decision.

Doctors who specialize in conditions of the urinary tract (urologists) perform most penile implants. Specially trained urologic surgeons usually do blood vessel repair surgery.

Other Treatment

Other treatments for erection problems (erectile dysfunction) include vacuum devices and counseling (psychotherapy).

Other Treatment Choices

• Vacuum devices are useful for all types of erection problems—physical, psychological, or both. The device has a tube you place around the penis. You pump the device to create a vacuum that leads to an erection. Then you place a band around the base of the penis to maintain the erection for up to 30 minutes.
• Counseling (psychotherapy) is recommended for men whose erection problems are caused, at least in part, by psychological factors. Psychological factors seem to be involved in many cases of erection problems. Treatment may include sex therapy, which focuses on methods to improve attitudes toward sex and specific sexual techniques. Counseling also may be used with medicine treatment or vacuum devices for erection problems that have psychological and physical causes. Evidence shows that group therapy helps with erection problems in some men. Adding group therapy to treatment with sildenafil (Viagra) helped more than Viagra alone. Men who were taking part in group therapy also were more likely to keep taking their medicine.¹

Although medicines are usually the main treatment for erection problems, some men try complementary therapies. If you don't want to use medicine, or medicine doesn't work for you, you may want to talk with your doctor about some of the following options. Most of these treatments need more research before doctors can know if they work for sure.²

• Acupuncture may work for some men with erection problems.
• Ginseng has been shown to work for some men with erection problems. But because it is sold as a dietary supplement, it is hard to know if you are getting the right amount.
• Some men take the amino acid L-arginine as a dietary supplement to try to treat erection problems. The amino acid increases the amount of nitric oxide in the blood, which relaxes blood vessels. In theory, L-arginine could improve erections. But L-arginine may be harmful.³
• Some men who have low zinc levels in their body have had success using zinc supplements to treat erection problems. But high doses of zinc can be dangerous.
• Some men have tried yohimbine to treat erection problems, but it is rarely used.

What to Think About

No matter what approach you use to treat an erection problem, including your partner in the decision is helpful and may improve results.