Our ED treatment protocols are based on the latest medical research, medical guidelines and our extensive clinical experience and we expect that 100% of our patients will be able to restore their erectile function. Each treatment plan is personalised and is multi-modal – in general, our treatment protocols will assist patients to achieve good on-demand erections and at the same time improve the quality of their natural erections – the protocols will typically consist of a combination of the following:

1. Control of risk factors for ED such as diabetes, hypertension and change/adjustment of medication that might have contributed to the ED issue                                                                                                                                                                                              

2. Lifestyle consulting for patients whose lifestyle contributes to the the ED issue and in particular providing assistance with weight loss, diet, exercise and reduction of stress among others                                                                                                                                                                                  

3. Basic in office sex therapy and in some cases psychosexual counselling                                                                                                                                                                                             

4. First line of on-demand treatment together with shockwave therapy – for newly diagnosed patients with up to moderate ED, with clear organic aetiology we recommend a treatment protocol with PDE-5 inhibitors for achieving on-demand erections together with shockwave therapy for penile rejuvenation. The type of medication and shockwave treatment protocol will depend on the severity of ED, treatment goals and patient profile and will be discussed extensively with the doctor during your consultation. For patients also suffering from low testosterone, the treatment protocol is supplemented with Testosterone Replacement Therapy                                                                                                                                                                                               

5. Second line of on-demand treatment together with shockwave therapy– for patients who have unsuccessfully tried in the past PDE-5 inhibitors or their use is contra-indicated then another on-demand treatment modality will be prescribed together with shockwave therapy. For most patients, the most appropriate second-line treatment will be injection therapy but other options include alpostadil MUSE pellets or Vitaros cream. For patients that do not want to undergo pharmacological treatment, another option is the use of a penis pump                                                                                                                                                                                              

6. Combination therapy – some patients will benefit from a combination of first and second line treatment options                                                                                                                                                                                              

7. Penile Implants – unfortunately for a small minority of patients (less than 10%) the natural erection mechanism has been destroyed and they will not respond to any conservative treatments. In this case, erectile function can be restored 100% with the implantation of a penile prosthesis                                                                                                                                                                                                          

8. Vascular surgery – For a few selected cases vascular surgery may improve natural erections and can be considered as an alternative treatment modality, before proceeding with the penile implant option                                                                                                                                                                                              

9. Pelvic floor exercises have shown to improve erectile function, strength and control of ejaculation and orgasm and we will typically instruct patients on how to do them during their consultation                                                                                                                                                                                              

10. Vacuum erection device exercises – there is a growing body of evidence that daily exercises with a vacuum pump (10 minutes per day) can help restore erectile function to patients that have undergone radical prostatectomy. Although no specific studies have been done, similar benefits might be observed on patients that suffer from ED for any organic aetiology and given that this is a safe treatment option with no side-effects, we usually recommended it to our patients.

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