What if Viagra fails?
Shawn Blick, MD,is a certified urologist at Banner Estrella Medical Center.
Question: Are there other options available for men if Viagra fails to help?
Answer: I assume that if you have tried Viagra, you have discussed your erection issues with a qualified urologist. Lack of response on the drug is something you should bring to your physician’s attention right away because there are, as you hoped, other options.
First, there are alternative oral medications available. Most likely you have seen commercials for Viagra’s two competitors—Levitra and Cialis. One of these medications might work for you as each has a different formulary.
If pills do not help, there are other, more invasive options that can help develop and maintain an erection. One option, injection therapy, involves use of a fine needle, similar to those used by diabetics, to inject prostaglandin, a group of chemicals typically made by the body’s cell membranes into the base of the penis. This option provides an erection in about 30 to 45 minutes. Of course, to use this option, you would have to be comfortable with self-injecting the prostaglandin.
Other options include a suppository, such as MUSE or a vacuum device. MUSE stands for “medicated urethral system for erections” and is a small pellet that users insert inside the urethra using a special applicator. The medication is absorbed through the membrane that lines the inside of the urethra providing an erection that can last approximately 60 minutes.
The vacuum is a tube made of plastic that fits around the penis. Air is pumped out of the tube after the penis in inserted into the tube, creating a vacuum. The vacuum helps blood flow, producing an erection, which is then controlled by a constrictive band placed at the base of the penis. The major problem with the three minimally-invasive options above is that they can be a “mood killer” because they require you to act within minutes of sexual activity.
Most men, if having to rely on injections or the vacuum, will choose to investigate the penile prosthesis implant. Penile prosthesis consist of a pair of malleable rods implanted into the erection chambers of the penis. This is a minimally invasive surgery, with a one-inch incision at the base of the penis. The rods are inflated and deflated using a pump in the scrotum. With the small incision, other people will not even be able to tell that you have an inflatable penile prosthesis. Penile implants are often covered by insurance and Medicare as they are considered a medical implant similar to a knee or a hip, not elective plastic surgery.
Your first step in finding out your options? Talk with your urologist or, if you don’t have an urologist, ask your primary care physician to refer you to an urologist in your area.