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I can’t believe this is happening to me! The ABC’s of Erectile Dysfunction

“Doc, I can’t get it up.”

“Dr. Christine, my penis doesn’t work anymore.”

“I have ED and it’s killing my marriage.”

No matter how a man tells me he has Erectile Dysfunction (ED), he is never happy about it. He is always frustrated and depressed. My practice is exclusively men’s sexual health and prosthetic urology.  I do not treat cancer. I do not save lives. But I know, and you folks reading this blog who have ED or love a man who has ED know, that treating erectile dysfunction is every bit as important as treating any other disease; for a lot of men it’s more important.

Erectile Dysfunction is the inability to achieve or maintain an erection that is rigid enough for penetrative sexual intimacy. The diagram below shows the anatomy of the penis. There are two cylinders of sponge-like tissue that fill with blood during an erection; these cylinders, each one called a Corprus Cavernosum, get very hard and stiff during a normal erection. If the blood flow into the Corpus is poor (or, if the valves that are supposed to keep the blood in the Corpus are defective) the penis does not get fully hard…..that’s ED.



Increasing age, medical conditions like diabetes and high blood pressure, pelvic surgery such as Radical Prostatectomy, and spinal cord injury can all lead to Erectile Dysfunction. It is important for patients to know that regardless of the cause of ED, it can always be treated. It happens almost every day in my practice that I see a man who has suffered with ED for years. Let me tell you, brothers, we can get you and your loved one back to having satisfying sexual activity!

How do you treat ED?  

Well, there are a several treatment options. The first line of therapy is oral medications like Viagra and Cialis. These medicines do not cause an erection; they increase blood flow into the penis when the patient is sexually aroused. You need to take them about an hour prior to sex. Some men have headaches or nasal congestion as side effects. The biggest drawback is often the price… insurance plans may not cover them and they can be $30 – $50 per pill.

There is no set order of treatments that a patient has to go through; after oral medicines, the next treatment is completely up to the patient.

Penile injection therapy can work well for some men. Yes, it’s exactly what you are thinking: the patient gives himself an injection into the penis.  If successful, the injection causes a rigid erection in 10-15 minutes, and the erection lasts about an hour. There is some pain with the injection, but the needle is very, very small.  A downside can be priapism from the injection; that’s an erection that will not go away (sounds great, but after 3 or 4 hours with a hard penis, men are really uncomfortable). The risk of priapism for Urology Centers of Alabama patients is very low.

Penile Implants are a surgical treatment for ED. These devices have been around for over 40 years, and they have the primary benefit of having the highest patient satisfaction rates. Over 90% of patients would highly recommend to a friend. That’s because they work. I do these surgeries for our practice, and the operation is most often done through a single 1-2 inch incision and takes me about 30-35 minutes as an overnight procedure. Penile implants are not the first treatment option, but they are great in the right patient.

A Vacuum Erection Device (VED) is a hollow plastic tube that fits over the penis and pulls blood into the penis; a rubber ring is placed around the base of the penis to hold the blood in. The VED is safe, but has the lowest patient satisfaction; for many men the erection is not very rigid, and the penis tends to wiggle and flop at the base.

If you, your husband or boyfriend has ED, come see us. We can get you back to an erection that will allow sex.  Don’t suffer without treatment. Don’t go to someplace that advertises seemingly magic treatments that will make your penis longer and better, only to find that they are mostly interested in charging you hundreds and thousands of dollars; I promise you that we will treat you as a valued patient.

I don’t save lives, but I do treat that condition that can hurt a man’s heart and mind like nothing else can. There is a treatment that will work for you.


Brian Christine, MD

Director of Erectile Restoration and Prosthetic Urology, Urology Centers of Alabama

Director of the Urology Centers of Alabama Fellowship in Men’s Sexual Health and Prosthetic Urology

Member of: The Sexual Medicine Society of North America

The Society of Urologic Prosthetic Surgeons

The International Continence Society

The European Association of Urology

Dr. Brian Christine, erectile dysfunction, sexual health, treatment for ED

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