Harvard Perspectives on Prostate Disease

Beyond Viagra and vacuum devices

Penile implants, an option patients with erectile dysfunction probably hear little about, might offer a lasting and satisfying "cure." Abraham Morgentaler, M.D., director of Men's Health Boston, explains how

Thanks to Viagra's introduction a decade ago, erectile dysfunction has become fodder for comedians, talk shows, and mainstream media. And there's clearly a market for Viagra (sildenafil) and its cousins, Cialis (tadalafil) and Levitra (vardenafil): the American Urological Association estimates that ED, as it's become known, affects 25 million American men.

All three medications have helped a significant number of men achieve an erection firm enough for intercourse. A 2001 study of Viagra's long-term effectiveness reported an overall success rate of 69%. The success rates for Cialis and Levitra were similar — 59% and 69%, respectively. However, the response can depend on what caused the ED in the first place. Men who have vascular problems as a result of diabetes or heart disease find that the drugs work only about half of the time. Response rates are lower — just 30% — for men who've had a radical prostatectomy.

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