What does ED look like? We all read the books and the definition is something like “not able to achieve an erection to have satisfactory sex”. Let’s personalize it a bit with some of our real patients and talk about their difficulty.
Patient A is a 55-year-old black male. His medical history is only remarkable for mild hypertension. Difficulties began “a couple of years ago” when he wasn’t able to have the quality erection he wanted. Soon after he had the occasional inability to get any erection. Initially oral agents (Viagra, Cialis) helped but they slowly became ineffective. Now he may be able to complete sex once or twice out of 10 attempts.
Patient B a 63-year-old white male. His medical history is totally unremarkable. He hasn’t been able to have sex in 5 or 6 years. You could visibly see the pain on his face when he talks about just passing a landmark anniversary with his wife and he said he didn’t even try to have sex.
Patient C is a 51-year-old white male Type I diabetic. He cannot even remember when his problems started but has had absolutely no function for “years”.
Patient D was a 58-year-old white male who had his prostate removed about 8 months prior. He had normal sexual function prior to surgery but has no function at all now.
Patient E is 45-year-old white male that functions “ok” but it takes more stimulation and longer to achieve an erection than it did in the past and he needs more time between encounters to function. He will be taking his wife to the beach on vacation in 2 weeks.
Patient F is a 71-year-old black male widower, whose wife passed away 2 years ago. Now he has found a friend and wants to become sexually active again and found nothing works.
Do you look like one of these people? Yes, these are real patients. Next, I will discuss each case and how they were treated.

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