Comparison of treatments

for erectile dysfunction (often thought as impotence)

Medication-based treatments for erectile dysfunction

PDE-5 inhibitors (mostly known: Viagra, Cialis etc.) are pharmaceutical agents that cause an enhanced and more effective dilation of blood vessels, which supply the corpora cavernosa with blood and thereby facilitating the formation of an erection. PDE-5 inhibitors are currently the first treatment option for erectile dysfunction and provoke, in about 70% of users, an erection. The inhibitors are not suitable for patients who suffer from severe cardiovascular disease or are taking medication for high blood pressure. Like all medicines, also PDE5 inhibitors have side effects; the most common include headache, indigestion, skin rash with flushing, muscle and back pain, dizziness and visual disturbances.

Another way to restore the erectile function, even for patients who do not respond to therapy with PDE-5 inhibitors, is the cavernous body auto-injection therapy. The patient injects itself with a very thin needle a vasoactive substance directly into the corpora cavernosa and experiences within 5-10 minutes the stiffening of its penis.

Apomorphine is having activity as a non-selective dopamine agonist which is used for treating ED. It works by stimulating directly a part of the brain, the hypothalamus. Apomorphine pills cause, like other medication – based treatments, painful side effects.

Non-medication based treatments for erectile dysfunction

A penis or vacuum pump is a plastic cylinder that is placed over the penis. By pumping, the air is drawn out of the container and a vacuum is created and thus has a negative pressure as result, which induces the blood to flow through the feeding vessels into the corpora cavernosa and generating an erection. After reaching the required reinforcement of the erection, the pump is removed and a constriction ring applied on the base of the penis, which prevents the blood to flow out from the corpora cavernosa and thus the decrease of the erection.

When all treatment options listed so far failed, a surgical implant of a penile prosthesis can influence the erectile function positively. There are malleable and hydraulically functioning models. The implantation of a penile prosthesis is irreversible. The penile tissues could have been severely damaged in such an engagement that, other future non-operative therapy methods will no longer be applicable.

The Spark Wave® therapy, a special shockwave treatment by MTS Medical, represents an innovative and long-term effective method for the treatment of erectile dysfunction (ED). This therapy leads to a significant improvement of the erectile function in patients and ensures their sexual spontaneity as well as the restored quality of life which come along therewith. The shockwave therapy relies on the treatment / elimination of the main cause of erectile dysfunction, namely the reduced blood supply to the penile tissue.

The effectiveness of the Spark Wave® therapy has been scientifically proven. Clinical studies show that the improvement of erectile function in patients after shock wave application persists for up to two years and approximately 50% to 60% of patients may stop taking PDE5 inhibitors-pills.

Therapy form

Effectivity

Pros

Cons

PDE5 inhibitors

  • Starts working in 10 – 60 minutes
  • Lasts 4 – 36 hours
  • Non-invasive treatment
  • Success rate 60% – 70%
  • Easy to take
  • several risk if taken with nitrate medications
  • facial flushing
  • headache
  • slight nausea
  • disturbed vision
  • nasal congestion
  • effects slowed by food and alcohol

Impotence injections

  • starts working in 10 – 15 minutes
  • lasts 60 – 90 minutes
  • success rate 70% – 75%
  • no interaction with nitrate medications
  • used only when required
  • tenderness in penis and testicles
  • occasional scarring
  • rare incidences of priapism (painful permanent erection)

Apomorphine

  • works by stimulating hypothalamus
  • starts working 5 – 15 minutes
  • doesn’t react to nitrate medication
  • oral treatment taken under the tongue
  • success rate over 60%
  • not affected by food or alcohol
  • mild nausea
  • mild headache
  • dizziness

Vacuum pumps

  • starts working immediately
  • „tension ring“ must be removed within 30 minutes
  • Drug – free
  • no interaction with other medications
  • slight bruising and pain
  • occasional pain/inability to ejaculate
  • rare incidents of priapism (painful permanent erection)
  • bulky to transport

Shockwave therapy

(e.g. Spark Wave® therapy)

  • Long – term effectiveness
  • Improvements after only one treatment
  • restores natural erection
  • Comfortable and easy treatment
  • No side effects
  • No pain
  • no interaction with other medications
  • one treatment takes about 10 – 15 minutes
  • drug – free
  • non – invasive
  • success rate?
  • stimulate vascular growth factors
  • regeneration of the penis tissue
  • development of new blood vessels
  • migration of stem cells
  • scientifically proven
  • No side effects
  • No complications
  • No pain