Cared for by Dr William Akakpo
Erectile dysfunction is common, treatable and frequently the first visible sign of a wider vascular or hormonal problem. Difficulty obtaining or maintaining an erection shares its risk factors with cardiovascular disease and diabetes, which is why the assessment always looks beyond the symptom itself. Testosterone deficiency may coexist, causing fatigue, low mood, loss of libido and reduced muscle mass. Treatment is proposed step by step, from lifestyle and medication to surgery, and a solution exists for essentially every patient.
Oral PDE5 inhibitors, correction of the contributing factors (smoking, sedentary lifestyle, diabetic control, sleep apnoea) and review of medications that impair erections. Dose and timing are adapted individually rather than prescribed generically.
Where a genuine deficiency is confirmed on two morning samples, replacement is started with structured monitoring of haematocrit, PSA and symptoms. Fertility implications are always discussed before starting.
Low-intensity shockwave therapy can improve penile blood flow in selected patients with mild to moderate vascular dysfunction. Intracavernosal injection therapy remains highly effective and is taught in consultation.
For men who no longer respond to medical treatment, a three-piece inflatable implant restores reliable, controlled and natural-feeling erections. Satisfaction rates for the patient and the partner exceed 90%, and the device is invisible when deflated.
It is the most effective treatment available, chosen once tablets and injections no longer work or are not tolerated. Many men regret only that they waited so long.
No. The pump sits in the scrotum and the reservoir behind the abdominal wall; the penis looks and feels normal when the device is deflated.
Current evidence does not show that properly monitored replacement causes prostate cancer, but PSA and a prostate assessment are checked before and during treatment.