Erectile Dysfunction

You’re Not Alone

Important Safety Information

Finding the Right Health Care Professional

Erectile dysfunction (ED) isn’t an inevitable part of aging that you have to accept. There are various treatment options available for men with ED, depending on the underlying cause. The sooner you explore these alternatives, the sooner you can return to enjoying intimate moments with your partner.

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Erectile Dysfunction Treatment Options

When pills aren’t an option, a penile implant can offer real hope. A penile implant is a medical device that is custom-fit and surgically placed into a penis to produce a natural-looking and natural-feeling erection.

The same healthy lifestyle tips your doctor has been recommending for years can also help treat your ED:

  • Quitting smoking
  • Reducing alcohol consumption
  • Losing weight
  • Exercising regularly
  • Reducing stress

These steps aren’t an instant fix, but they’ll improve your blood flow and nerve functioning. This should give you more energy and may reduce the severity of your ED in the process.

When lifestyle changes alone don’t work, drug therapy is normally the next step. Medications called PDE5 inhibitors can help to treat erectile dysfunction by increasing blood flow to the penis. There are 4 types, the most common known as Sildenafil (Viagra) or Tadalafil (Cialis). They are not suitable for everyone, and they can cause side effects such as headaches, heartburn, palpitations, and back pain. Before taking this medication, speak to a heath care professional, as these medications are not safe for everyone, especially if you have certain medical conditions or take specific medications.

In addition to tablets, Injections can be used to treat ED. They are easily administered, but they can cause side effects such as penile pain, bruising and scaring. Injection therapy can only be offered in secondary care under supervision. Intra urethral (via the urethra (waterpipe) can also be considered, although easy to administer, the medication has to be kept in the fridge. Side effects including pain, and it can not be used in pregnancy or when trying to conceive.

Also called vacuum constriction devices, penile pumps are devices that are placed over the penis to draw blood into the shaft. Once the vacuum creates an erection, the constriction ring is slid down to the lower end of the penis and the pump is removed. You can leave the ring on for a maximum of 30 minutes. The penis can feel cold to the touch and look slightly blue/purple in colour as the ring is trapping deoxygenated blood returning to the body.

When other treatments haven’t helped, a penile implant could be the right solution. A penile implant is a medical device that is surgically placed into a penis to produce a natural-looking and natural-feeling erection. Implants are custom-fitted to your anatomy. Sensitivity and the ability to ejaculate aren’t typically affected either, so you’ll be able to have an orgasm normally (unless you have a medical condition that prevents this).

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Finding the Right Doctor

If you think you might have erectile dysfunction, your doctor has years of experience treating men just like you. Remember, the sooner you begin the process of regaining control of your sexual health, the sooner you can go back to sharing and enjoying intimate moments with your significant other.

Clare Akers, men’s health nurse specialist

Clare completed her Msc in Nursing and is a non-medical prescriber. She has experience of running tertiary referral nurse led clinics in erectile dysfunction offering patients pharmacological treatments, as well as counselling patients for penile prosthesis surgery and managing their care post operatively.

In 2020 Clare was runner up “ Nurse of the year 2020 British Journal of Nursing Awards”.

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Titan® and Titan® Touch Inflatable Penile Prosthesis – Important Safety Information

A penile implant, also called a penile prosthesis, is concealed entirely within the body to address erectile dysfunction (impotence). The implant requires some degree of manipulation before and after intercourse to make the penis erect or flaccid.

Indications
The Titan and Titan Touch Inflatable Penile Prosthesis is indicated for male patients suffering from erectile dysfunction (impotence) who are considered to be candidates for implantation of a penile prosthesis.

Contraindications
The Titan Inflatable Penile Prosthesis is contraindicated in patients who have one or more of the following conditions:

  • Patients with an active infection present anywhere in the body, especially urinary tract or genital infection
  • Patients with a documented hypersensitivity or allergic reaction to silicone or polyurethane
  • Patients with unresolved urinary problems such as an elevated residual urine volume secondary to bladder outlet obstruction or neurogenic bladder

Warnings

It is the responsibility of the physician to advise the prospective patient prior to surgery, of the warnings associated with the use of this product and the associated surgical risks. The Titan Inflatable Penile Prosthesis should only be implanted by physicians experienced in the surgical procedures and techniques involving implantation of a penile prosthesis. The physician should maintain adequate education to conduct this procedure.

  • Implantation of a penile prosthesis makes latent natural erections, as well as other interventional treatment options, impossible.
  • Implantation of a penile prosthesis may result in penile shortening, curvature or scarring.
  • Pre-existing abdominal or penile scarring or contracture may make surgical implantation more complicated or impractical.
  • Failure to evaluate and promptly treat erosion may result in a substantial worsening of the condition, leading to infection and loss of tissue.
  • Men with diabetes as well as immunocompromised patients, may have an increased risk of infection which could result in permanent damage to tissue/organs.
  • Should surgical, physical, psychological, or mechanical problems occur, removal of the prosthesis may be indicated.
  • Patient – Related Warnings
    • Titan cylinders are straight and allow for radial expansion of up to 30%. Post-implant penile size, girth and angle can vary based on patient anatomy, cylinder implant size, level of inflation, and presence of Peyronie’s disease.
    • Excessive stresses or manipulations that may occur during daily routines such as vigorous exercise, athletics, manual massage and intimate physical contact could cause damage/separation to the implant and/or components (penile cylinders, pump/reservoir, and tubing).
    • Patients must be warned that any movements or activities that put pressure directly on the pump or deflate mechanism can cause involuntary erection or deflation. This includes, but is not limited, to straddle seating, such as on motorcycles, bicycles, horses, etc. Obesity may also be a contributing factor for stresses and pressure.
    • Capsule formation around device components is a physiological reaction to the device. The natural capsule that forms around the pump may activate the inflate/deflate mechanism and cause involuntary inflation or deflation. If the normal capsule forms around a constantly deflated reservoir and inflated cylinders in the 3 to 4 months postoperatively, subsequent inflation of the reservoir and deflation of the cylinders may be difficult or impossible. Cylinders must remain deflated and the reservoir totally inflated during capsule formation. After learning usage of the device, the patient must keep the cylinders deflated most of the day to encourage a capacious capsule development around the reservoir.
    • Patients may experience pain during the postoperative period (e.g., glans, scrotum).
    • Intra-abdominal pressure can cause fluid to be spontaneously transferred to the cylinders causing autoinflation if the Lock-Out valve is compromised by tissue ingrowth or pressure from neighboring anatomy.
  • Product – Related Warnings
    • Do not use product that has damaged or opened packaging, as sterility may be compromised potentially increasing the risk of infection which could result in permanent damage to tissue/organs.
    • Do not use expired product as such use may increase the risk of infection which could result in permanent damage to tissue/organs or improper function.
    • Reuse of this single use product may create a potential harm to the physician, medical staff and/or patient. Reprocessing, washing, disinfection and/or resterilization may compromise product characteristics, causing additional risk of physical harm to or infection of the physician, medical staff and/or patient.

Precautions
Removal of an implanted prosthesis without timely reimplantation of a new prosthesis may complicate subsequent reimplantation or may make it impossible. MRI quality may be compromised if the area of interest is in the exact same area or relatively close to the position of the Titan, and Titan Touch IPP. Be sure to consult with your physician. Patients should discuss all available treatment options and their risks and benefits with their physician. Health conditions which hamper sexual activity, such as severe chest pain (angina), may prevent successful use of this device. The prosthesis should not be implanted in patients who lack the manual dexterity or strength necessary to operate the device. Trauma to the pelvic or abdominal areas, such as impact injuries associated with sports (e.g. bicycle riding), can result in damage of the implanted device and/or surrounding tissues. This damage may result in the malfunction of the device and may necessitate surgical correction, including replacement of the device. The device may be used in the presence of Peyronie’s Disease.

Potential Complications
Penile implants are surgical solutions requiring a healing period that have risks associated with surgery such as scrotal swelling, autoinflation, discomfort, angulation/curvature, edema (swelling), device malfunction, chronic pain, difficulty with ejaculation, transient urinary retention, fever, migration, patient dissatisfaction, infection at surgical site or wound, deflation, hematoma/seroma (swelling of clotted blood or clear fluid), wound leakage, bleeding, delayed wound healing, phimosis (narrowing of the opening of the foreskin), sensory loss, cylinder malfunction, fibrous capsule formation (formation of thick tissue), over/under inflation, erosion, erythema (scrotal reddening), genital change, and inguinal hernia.

This treatment is prescribed by your physician. Discuss the treatment options with your physician to understand the risks and benefits of the various options to determine if a penile implant is right for you.

Before use, always consult the ‘Instruction For Use’ document delivered with the products/devices.

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