By DR. DAVID B. SAMADI
Earlier this week, I was discussing treatment options for erectile dysfunction with a 60-year-old patient — neither Viagra nor Cialis seemed to be working for him. Whether it be because of interactions with other prescriptions, side effects of Viagra/Cialis or other reasons, some men are just unable to take these medications. He expressed his frustration with the lack of efficacy of these oral medications, but I assured him that there was a solution suitable for him.
Current estimates show that approximately 30 million men in the U.S. and 300 million men worldwide are affected by erectile dysfunction (ED). Studies have demonstrated that a majority of these cases are a result of vascular problems, including insufficient blood flow, in addition to extensive nerve damage, whether from injury or surgery.
A typical course of ED treatment includes a regimen of Viagra, Levitra or Cialis, all designed to dilate the vessels supplying blood to the penis. While this is often a successful solution, about half of the population who are prescribed this drug therapy must discontinue it because it doesn’t work or they cannot tolerate the side effects. Furthermore, men who are prescribed certain drugs for heart disease are unable to use these medications because of possible interactions. So what are these men to do?
Medtronic, a medical device company perhaps best known for their cardiovascular stents, has designed a new stent to be placed in the major artery that supplies blood to the penis. Stents are tiny devices designed to prop open blood vessels. This particular stent is coated with a medicine that prevents arterial blockage and thus, allows for sufficient blood flow. The procedure to place this stent is only 1-2 hours and a preliminary trial has demonstrated no adverse events. This trial, conducted by Medtronic, found that 2/3 of men who received the stent saw an improvement in erectile function, as measured by the Internal Index of Erectile Dysfunction, and a dramatic increase in blood flow to the penis, confirmed by ultrasounds.
Although the trials for this device are still in their beginning phases, it will likely be a promising treatment option for men a few years down the road. Until then, speak with your physician, as my patient did, about all ED treatment options and find one that is appropriate for you. In my patient’s case, a penile pump proved to be the successful ED treatment of choice.
For more information on erectile dysfunction and penile rehabilitation, please read my blog.
Dr. Samadi is Vice Chairman of the Department of Urology and Chief of Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center.