Erectile Dysfunction (ED) Care
Erectile dysfunction is common—and treatable. We offer a stepwise, evidence-based approach to identifying the cause of ED and matching you with effective options, from lifestyle optimization and oral medications to advanced therapies like injections and penile implants.
Stepwise, practical care
We start with the least invasive options and escalate only if needed—based on your goals, health history, and what has (or hasn’t) worked before.
ED can reflect vascular health
Because erections depend on healthy blood flow, ED can be an early sign of cardiovascular risk. We coordinate evaluation when appropriate.
Penile implant expertise
For men who want a durable solution when other therapies aren’t effective or tolerated, penile implants can restore reliable function with high satisfaction.
Common Causes of Erectile Dysfunction
ED usually has more than one contributing factor. Identifying the “why” helps us choose the most effective treatment plan.
- Vascular: reduced blood flow (hypertension, high cholesterol, diabetes, smoking)
- Neurologic: nerve injury or conditions affecting nerve signaling
- Hormonal: low testosterone or endocrine disorders (in select cases)
- Medication-related: certain blood pressure meds, antidepressants, etc.
- Psychological: stress, anxiety, depression, relationship factors
- Post-prostate treatment: ED after prostatectomy or radiation is common and treatable
If symptoms are sudden, severe, or associated with chest pain or shortness of breath, seek urgent medical attention.
What ED can look like
- Difficulty achieving an erection
- Difficulty maintaining an erection for intercourse
- Reduced rigidity or less reliable erections
- Changes after surgery, radiation, or new medication
ED is very common, and you’re not alone—our job is to help you get a plan that works.
How We Evaluate ED
Most evaluations can be completed with a focused visit and selective testing.
- Medical and sexual history (onset, consistency, morning erections, libido)
- Review of medications and risk factors (diabetes, BP, cholesterol, smoking)
- Physical exam when appropriate
- Targeted labs when indicated (e.g., testosterone, A1c, lipids)
- Discussion of goals: spontaneity, firmness, reliability, and comfort
What to bring
- Medication list
- Recent lab results (if available)
- History of prior ED treatments tried and response
- If post-prostate treatment: operative and/or radiation summary if available
We can often make a treatment plan at the first visit.
Treatments for ED
We tailor therapy to your health, preferences, and desired level of spontaneity. Many men benefit from a combination approach.
Lifestyle & Risk-Factor Optimization
Improving vascular health often improves erectile function and response to medication.
- Exercise and weight management
- Sleep and stress reduction
- Smoking cessation
- Optimizing diabetes, blood pressure, and cholesterol
Oral Medications (PDE5 inhibitors)
Common first-line therapy for many men. We’ll guide safe use and dosing strategy.
- Examples: sildenafil, tadalafil, vardenafil
- Best results when taken correctly with appropriate timing
- Not compatible with nitrate medications—your urologist will review safety
If pills don’t work, it doesn’t mean “nothing will”—it just means it’s time for the next option.
Vacuum Erection Device (VED)
A non-medication option that can be used alone or with other treatments.
- Creates an erection using negative pressure
- Can help penile rehab after prostate treatment
- Often combined with a constriction ring
Injection Therapy / Urethral Medication
Highly effective for many men, especially when oral medications don’t work or aren’t tolerated.
- In-office teaching for safe technique
- Rapid onset and strong rigidity for many patients
- We’ll review dosing, side effects, and safety precautions
Penile Implant (Penile Prosthesis)
A penile implant is a surgically placed device that restores reliable erections for men who do not respond to—or prefer not to use—other therapies. It is a durable solution with high patient and partner satisfaction.
- Goal: predictable, on-demand function
- Who it helps: men with medication-resistant ED, post-prostate treatment ED, severe vascular disease, or those wanting a definitive solution
- What to expect: a structured plan before surgery, clear recovery guidance, and teaching on device use
We’ll discuss candidacy, benefits, risks (including infection), and the timeline from surgery to full use.
Penile Implant Walkthrough with Dr. Lacy
Fellowship-trained male reconstructive urologist Dr. John Lacy reviews penile implant surgery at a high level, including: pre-op checklist, perioperative expectations, and how the implant is used.
If you’re considering an implant—or want to explore all options—contact us for a consultation.
Schedule an ED Consultation
We’ll review your symptoms, medical history, prior treatments, and goals—then build a plan that fits you.
Contact University Urology
University of Tennessee Medical Center
1928 Alcoa Highway, Building B, Suite 222 • Knoxville, TN 37920
Hours: Mon–Fri 8:00–4:30 • Satellite office hours vary by provider and location.