Erectile Dysfunction (or Impotence) is a man’s inability to attain and/or maintain an erection sufficient enough for sexual activity.  Its persistence tends to cause personal issues such as stress, relationship problems, and affect self-confidence, which in turn makes it even more difficult to attain.


Progressive Urology is here to help! Make an appointment if the following signs and symptoms are present:

  • Trouble attaining an erection
  • Trouble maintaining an erection
  • Reduced sexual desire



There are many factors that go into obtaining an erection – emotions, hormones, muscles, blood vessels, nerves and the brain.  Thus, the diagnosis is an equally complex process.  Doctors need to distinguish between two categories that can contribute to impotence:  Physical and/or Psychological causes.

Physical Causes:

  • Diabetes
  • Kidney Disease
  • Neurological Disorder (stroke, multiple sclerosis, Alzheimer’s disease, Parkinson’s disease)
  • Vascular Diseases (atherosclerosis, high blood pressure, high cholesterol)
  • Enlarged Prostate or BPH
  • Prostate Cancer treatment

Other potential physical causes that are not necessarily disease-related include:

  • Injury to the brain, spinal cord, pelvic, bladder, and penis
  • Surgery for prostate cancer and bladder cancer
  • Tobacco, alcohol or recreational drug use
  • Prescription drugs
  • Hormone problems (Low Testosterone)
  • Venous leak (usually caused by injury or surgery)

Psychological Causes: 

  • Mental health conditions such as depression or anxiety
  • Stress
  • Exhaustion
  • Relationship troubles

Although these causes can be primary contributing factors, many times they are responsible for worsening temporary impotent issues.


Diagnosis/ Workup

The possible causes of ED are disparate; therefore, finding the underlying source of your symptoms requires a variety of tests to rule out every case.

Psychological Evaluation

  • Doctor will ask series of questions to screen for depression, anxiety and other psychological causes

Physical exam

  • Breast enlargement to rule out hormonal issues
  • Pulse to rule out any vascular issues (blood flow problems)

Blood Test

  • Cholesterol
  • Testosterone
  • Glucose

Urine Tests

  • Urinalysis to rule out diabetes and other health conditions


  • Penile Doppler Ultrasound (or Penile Duplex) to check for blood flow to the penis

Overnight Erection Test

  • RigiScan Monitor measures enlargement and rigidity of the penis by the loops tightening discretely at intervals during the night.



Erectile Dysfunctionis essentially caused by an underlying condition, sometimes unrelated to urology.  Thus, treatment heavily depends on the source of the problem.  First, your doctor will ensure that you are receiving proper treatment for the primary condition causing or worsening your ED.

Lifestyle Changes

  • Quit smoking
  • Lose weight
  • Exercise regularly
  • Treat alcohol and drug abuse
  • Work out relationship issues

Oral Medications

  • Sildenafil (Viagra)
  • Tadalafil (Cialis)
  • Vardenafil (Levitra, Staxyn)


  • Alprostadil Injections or Intracavernous Injections where a fine needle is used to inject aslprostadil into the base of the penis producing an erection within 20 minutes.  Typically used as an alternative for men who failed to respond to oral medications and also recommended for men with diabetes, heart conditions, hypertension and other illnesses.

Hormone Replacement

  • Testosterone replacement for men with ED due to low levels of testosterone

Penile Implants and Surgeries

  • Inflatable Penile Prosthesis is a device made up of two rods implants into sides of the penis that are inflated and deflated as desired.