{"id":611,"date":"2014-04-03T20:25:00","date_gmt":"2014-04-04T00:25:00","guid":{"rendered":"https:\/\/med.sites.unc.edu\/urology\/patientinfo\/adult-non-cancer\/mens-health\/erectile-dysfunction\/"},"modified":"2026-03-12T10:41:26","modified_gmt":"2026-03-12T14:41:26","slug":"erectile-dysfunction","status":"publish","type":"page","link":"https:\/\/www.med.unc.edu\/urology\/patientcare\/adult-non-cancer\/mens-health\/erectile-dysfunction\/","title":{"rendered":"Erectile Dysfunction"},"content":{"rendered":"<p>UNC Urology has expertise in all aspects of male erectile dysfunction diagnosis and its medical and surgical treatment. We provide clinical evaluation, as well as radiographic, ultrasound, and nocturnal penile tumescence studies. Medical and surgical procedures for the treatment of male erectile dysfunction include the latest in medical management, as well as penile prosthesis implantation, penile vascular procedures, and genital reconstructive techniques.<\/p>\n<div role=\"tablist\" class=\"panel-group  oscitas-bootstrap-container\" id=\"unc-accordion-0\">\n\n<div class=\"panel panel-default oscitas-bootstrap-container\">\n\n    <div id=\"panel-heading-details-0-0\" class=\"panel-heading oscitas-bootstrap-container\" role=\"tab\">\n\n        <h2 class=\"panel-title oscitas-bootstrap-container\">\n\n            <button class=\"accordion-toggle oscitas-bootstrap-container collapsed\" \n                id = \"button-details-0-0\"\n                data-toggle=\"collapse\"\n                data-parent=\"#unc-accordion-0\"    \n                aria-controls=\"#details-0-0\"  \n                aria-expanded=\"false\" \n                href=\"#details-0-0\">\n                Overview            <\/button>\n\n        <\/h2>\n\n    <\/div>\n\n    <div id=\"details-0-0\" class=\"panel-collapse collapse  oscitas-bootstrap-container\">\n\n        <div class=\"panel-body oscitas-bootstrap-container\">\nErectile dysfunction (ED) is defined as the \u201cconsistent or recurrent inability to obtain and\/or maintain a penile erection sufficient for sexual performance.\u201d ED is a highly prevalent condition, affecting nearly half of all men aged 40-70 years to some degree.<\/p>\n<p>There are currently approximately 30 million men in the US suffering from ED, and it is expected that the worldwide prevalence of ED will surpass 300 million men by 2025. ED often has a profound effect on quality of life and is often associated with other medical conditions, including diabetes, hypertension, hyperlipidemia, obesity, smoking, and coronary artery disease. In fact, ED can serve as an early indicator underlying cardiac disease in an otherwise asymptomatic man. ED is a progressive disorder that increases with age. Likewise, additional risk factors may increase the severity of ED, for example, the presence of diabetes approximately doubles the risk of ED. Risk factors for ED include depression, hypertension, hyperlipidemia, and smoking, and the presence of more than one risk factor greatly increases the likelihood of ED. Fortunately, multiple treatment options are available, and almost all men can be successfully treated to restore sexual function.<br \/>\n<\/div>\n\n    <\/div>\n        \n<\/div>\n\n<div class=\"panel panel-default oscitas-bootstrap-container\">\n\n    <div id=\"panel-heading-details-0-1\" class=\"panel-heading oscitas-bootstrap-container\" role=\"tab\">\n\n        <h2 class=\"panel-title oscitas-bootstrap-container\">\n\n            <button class=\"accordion-toggle oscitas-bootstrap-container collapsed\" \n                id = \"button-details-0-1\"\n                data-toggle=\"collapse\"\n                data-parent=\"#unc-accordion-0\"    \n                aria-controls=\"#details-0-1\"  \n                aria-expanded=\"false\" \n                href=\"#details-0-1\">\n                Evaluation            <\/button>\n\n        <\/h2>\n\n    <\/div>\n\n    <div id=\"details-0-1\" class=\"panel-collapse collapse  oscitas-bootstrap-container\">\n\n        <div class=\"panel-body oscitas-bootstrap-container\">\nED can be classified as:<\/p>\n<div class=\"row  oscitas-bootstrap-container\">\n<div class=\"col-lg-6 col-md-12 col-xs-12 col-sm-12 oscitas-bootstrap-container\">\n<ul>\n<li>psychogenic<\/li>\n<li>neurogenic<\/li>\n<li>vasculogenic<\/li>\n<\/ul>\n<\/div>\n<div class=\"col-lg-6 col-md-12 col-xs-12 col-sm-12 oscitas-bootstrap-container\">\n<ul>\n<li>hormonal<\/li>\n<li>drug-induced<\/li>\n<li>associated with systemic disease<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<p>In reality, most cases of ED are multifactorial. Evaluation of the man with ED involves a complete history, including medical conditions, medications, and a complete physical examination. Basic lab tests may include serum testosterone, creatinine, CBC, Hemoglobin A1C, and lipid profile. Validated questionnaires, such as the International Index of Erectile Function (IIEF), can be utilized for objective measurement of patient-reported erectile function. For complex patients, further tests can be utilized to evaluate penile blood flow. These include intracavernosal injection of medications in order to produce an erection, which can be combined with penile Doppler ultrasound to measure arterial flow and venous leak within the penis during erection.<br \/>\n<\/div>\n\n    <\/div>\n        \n<\/div>\n\n<div class=\"panel panel-default oscitas-bootstrap-container\">\n\n    <div id=\"panel-heading-details-0-2\" class=\"panel-heading oscitas-bootstrap-container\" role=\"tab\">\n\n        <h2 class=\"panel-title oscitas-bootstrap-container\">\n\n            <button class=\"accordion-toggle oscitas-bootstrap-container collapsed\" \n                id = \"button-details-0-2\"\n                data-toggle=\"collapse\"\n                data-parent=\"#unc-accordion-0\"    \n                aria-controls=\"#details-0-2\"  \n                aria-expanded=\"false\" \n                href=\"#details-0-2\">\n                Treatment            <\/button>\n\n        <\/h2>\n\n    <\/div>\n\n    <div id=\"details-0-2\" class=\"panel-collapse collapse  oscitas-bootstrap-container\">\n\n        <div class=\"panel-body oscitas-bootstrap-container\">\nTreatment begins with a shared-decision making approach with the patient to determine the effect of ED on the patient\u2019s and partner\u2019s quality of life. If treatment is desired, an evaluation of the man\u2019s cardiac risk may be recommended.<\/p>\n<p>If the patient is considered high risk for a cardiac event, then formal cardiac evaluation is warranted prior to beginning therapy. Lifestyle modifications are first-line treatment options. These include weight loss, tobacco cessation, and medical management of any associated conditions (HTN, DM, dyslipidemia). Additionally, any medications that may contribute to ED should be altered, if possible (beta blockers, diuretics).<\/p>\n<p>Medical treatment of ED began with intracavernosal injection agents in the 1980\u2019s. Medications include prostaglandin E1, papaverine, and phentolamine. Later in the 1980\u2019s, intraurethral suppositories of alprostadil were approved (MUSE). In 1998, sildenafil was approved as the first phosphodiesterase type 5 inhibitor and revolutionized ED therapy. Since then, tadalafil and vardenafil have been approved in the US. These medications increase the erectile response to normal sexual stimulation. Common side effects include a headache, flushing, nasal congestion, and vision changes (blue tint). These are all mild and temporary.<\/p>\n<p>Surgical treatment of ED is for men who have failed conservative measures. Placement of an <a class=\"external-link\" title=\"\" href=\"http:\/\/www.urologicalcare.com\/advanced-ed-treatments\/internal-penile-pump\/\">inflatable penile prosthesis<\/a> (IPP) is a very important consideration for patients who have failed oral therapy or who don\u2019t want to continue injection therapy. An IPP is the most common procedure performed for ED with very high success and satisfaction rates. Developed in 1973, penile implants have now been on the market for over 40 years. IPP is the best long-term solution for severe ED, as the erection feels natural to the patient and his partner, it functions anytime one chooses and is maintained as long as desired. Covered by Medicare and most private insurance carriers, an IPP is an outpatient operative done with general or spinal anesthesia. Performed through a small hidden scrotal incision, a penile implant is invisible in your body while producing a completely natural erection and sexual experience. Sensation, orgasm, ejaculation, and urination are unaffected. The IPP has the highest success rate of all the treatments for Peyronie\u2019s disease and erectile dysfunction, and over 90% of men and their partners are satisfied after the procedure.<br \/>\n<\/div>\n\n    <\/div>\n        \n<\/div>\n\n<div class=\"panel panel-default oscitas-bootstrap-container\">\n\n    <div id=\"panel-heading-details-0-3\" class=\"panel-heading oscitas-bootstrap-container\" role=\"tab\">\n\n        <h2 class=\"panel-title oscitas-bootstrap-container\">\n\n            <button class=\"accordion-toggle oscitas-bootstrap-container collapsed\" \n                id = \"button-details-0-3\"\n                data-toggle=\"collapse\"\n                data-parent=\"#unc-accordion-0\"    \n                aria-controls=\"#details-0-3\"  \n                aria-expanded=\"false\" \n                href=\"#details-0-3\">\n                Other Resources            <\/button>\n\n        <\/h2>\n\n    <\/div>\n\n    <div id=\"details-0-3\" class=\"panel-collapse collapse  oscitas-bootstrap-container\">\n\n        <div class=\"panel-body oscitas-bootstrap-container\">\n<a class=\"external-link\" title=\"Sexual Medicine Society of North America\" href=\"http:\/\/www.sexhealthmatters.org\/erectile-dysfunction\">Sexual Medicine Society of North America<\/a><\/p>\n<p><a class=\"external-link\" href=\"https:\/\/www.urologyhealth.org\/urologic-conditions\/erectile-dysfunction\">Urology Care Foundation<\/a><br \/>\n<\/div>\n\n    <\/div>\n        \n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>UNC Urology has expertise in all aspects of male erectile dysfunction diagnosis and its medical and surgical treatment. We provide clinical evaluation, as well as radiographic, ultrasound, and nocturnal penile tumescence studies. Medical and surgical procedures for the treatment of male erectile dysfunction include the latest in medical management, as well as penile prosthesis implantation, &hellip; <a href=\"https:\/\/www.med.unc.edu\/urology\/patientcare\/adult-non-cancer\/mens-health\/erectile-dysfunction\/\" aria-label=\"Read more about Erectile Dysfunction\">Read more<\/a><\/p>\n","protected":false},"author":80868,"featured_media":0,"parent":231,"menu_order":83,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"layout":"","cellInformation":"","apiCallInformation":"","footnotes":"","_links_to":"","_links_to_target":""},"class_list":["post-611","page","type-page","status-publish","hentry","odd"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Erectile Dysfunction | Department of Urology<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.med.unc.edu\/urology\/patientcare\/adult-non-cancer\/mens-health\/erectile-dysfunction\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Erectile Dysfunction | Department of Urology\" \/>\n<meta property=\"og:description\" content=\"UNC Urology has expertise in all aspects of male erectile dysfunction diagnosis and its medical and surgical treatment. 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