Erectile Dysfunction

By David Harris, M.D. –

Q: My husband likes the option of treating erectile dysfunction with a pill because of the simplicity, but would that be dangerous after a coronary stent placement several months ago?

A: Viagra, Cialis, and Levitra are PDE5 inhibitors that work by dilating blood vessels to increase penile blood flow. They are safe and effective but can cause a dangerous drop in blood pressure if taken with medicines called nitrates. Specifically, men with unstable angina and those prescribed nitrates should not take PDE5 inhibitors. Be assured that many cardiac patients are fine to take PDE5 inhibitors, including men with mild coronary artery disease without angina and those men successfully revascularized with a bypass graft or coronary stent.

Q: I am grateful that a screening PSA detected a significant prostate cancer and will be treating it for cure. If cancer therapy results in erectile dysfunction can it be treated successfully?

A: Fortunately, the newest curative treatments such as daVinci® robotic prostatectomy with nerve-sparing and TrueBeam™ radiotherapy allow most potent men to maintain or return to sexual activity. We now employ daily Cialis® 5 mg and vacuum devices from the time of treatment to allow couples to remain intimate. While patients have individual medical issues and preferences, ALL men can successfully treat erectile dysfunction. A urologist can review the options of oral medication, penile injections, vacuum devices, intra-urethral suppositories, and placement of an inflatable penile prostheses.