Erectile dysfunction


Thankfully there is nowadays much more awareness of the problem of erectile dysfunction than previously and most men have heard of the availability of drug treatments such as Viagra, Cialis and Levitra. However not all men will respond to such treatments and others will find them unsuitable for their particular circumstances. Such men require expert evaluation to determine the causes of the problem in order that the appropriate treatment can be provided.

What can we offer?

We offer a wide range of investigations, by no means all of which will be required by every patient. Many will have already had their hormones tested but some will not. All men should have a detailed consultation and clinical examination at which time a full history will be taken. Often a test injection will be given to see if this enables the man to obtain an erection. Should this be the case then that can be offered as a form of therapy. If not then further investigation may be warranted such as colour Doppler ultrasound or monitoring of the overnight erections (NPT monitoring).


Nowadays there are a wide range of treatments that may be appropriate depending on the cause of the problem. These range from oral drugs (Viagra, Cialis, Levitra) to injections such as Caverject. Vacuum devices are an alternative to drug therapies and may work when drugs do not.

Shockwave therapy (eg ED1000) is a revolutionary treatment for erectile dysfunction. This is a non-invasive treatment which uses low intensity shock waves to stimulate formation of new blood vessels in the penis, thus increasing penile blood flow and helping men to achieve a stronger erection. The treatment takes place over a number of sessions, it is painless and no anaesthesia or sedation is required. Patients generally feeling a gentle “tapping” sensation, and there are no reported side effects.


Abnormalities of the penile vasculature that are amenable to surgery are rare but reconstructive surgery in such cases gives very good results. It is essential therefore for such patients to have expert assessment by the radiologists and surgeons working together to determine whether they are likely to benefit from such surgery.

Other options

If none of the other treatments prove of benefit then it is always possible to restore a man’s ability to have sexual intercourse by the implantation of a penile prosthesis. These give the penis enough rigidity to have sex and come in a variety of types. The simplest are the semi-rigid malleable prostheses but many men prefer the hydraulic devices that can be deflated when the erection is not required. Our surgeons have more experience of implanting these devices than any other centre in the UK.
Erectile dysfunction: introduction

In the video below, David Ralph discusses erectile dysfunction.

Erectile dysfunction: Causes

David Ralph discusses the causes of erectile dysfunction.

Erectile dysfunction: Treatments

David Ralph talks through treatment options for erectile dysfunction