It is probably a bit less effective than the direct injection. An alternative to this invasive approach is the use of a plastic tube and suction pump to create a vacuum around the penis. When an erection results, a rubber band is placed at the base of the penis and satisfactory coitus can occur. A third choice is surgical implantation of one of several types of prostheses. These have been used successfully by many couples.
Sex therapy is especially helpful for psychogenic erectile dysfunction.
Supportive counseling and reassurance are a necessary adjunct for all patients with erectile dysfunction, particularly because anxiety and fear of failure compound any partial erectile difficulty. Anew drug application has been submitted for sildenafil, and an oral form of phentolamine is in phase III trials. The most frequent clinical presentation of erectile dysfunction is in apparently normal men older than 50 years. The clinical significance of any gradual decline in testicular function in men older than 50 years is receiving renewed study. Although there is much individual variation, aging men generally experience a gradual decline in sexual activity.