Urology · University Urology, PC · Knoxville, TN
Erectile Dysfunction (ED)
Erectile dysfunction is common, treatable, and often a signal of underlying cardiovascular or hormonal health. From medication to surgical options, University Urology offers the full spectrum of ED evaluation and treatment — including penile prosthesis implantation.
About ED
What Is Erectile Dysfunction?
Erectile dysfunction is the consistent inability to achieve or maintain an erection sufficient for satisfactory sexual activity. It affects approximately 30 million men in the United States and becomes more prevalent with age — but it is not an inevitable consequence of aging.
ED as a cardiovascular signal
ED is often the first manifestation of endothelial dysfunction and may precede cardiovascular events by 2–3 years. An ED evaluation is also a health evaluation. Cardiovascular risk factors should be assessed and addressed alongside treatment.
Common Contributing Factors
Diabetes · Hypertension · High cholesterol · Obesity · Smoking · Low testosterone · Prostate cancer treatment (surgery or radiation) · Peyronie’s disease · Psychological factors
Treatment Options
ED Treatment at University Urology
Oral Medications (PDE5 Inhibitors)
Sildenafil (Viagra), tadalafil (Cialis), vardenafil, and avanafil are first-line treatments for most men. Daily low-dose tadalafil also improves urinary symptoms from BPH.
Vacuum Erection Device
A non-invasive mechanical device that draws blood into the penis. Effective and safe. Useful for men who cannot take oral medications or prefer a drug-free option.
Penile Injection Therapy
Self-injected vasoactive medications directly into the penis produce reliable erections within 5–15 minutes. Effective even in men who do not respond to oral medications.
Penile Prosthesis (IPP)
A surgically implanted device that provides reliable, on-demand erections. The most durable and satisfying long-term solution for men with refractory ED. Dr. Lacy is the primary implanter; Dr. Kim also performs this procedure.
Testosterone Optimization
Low testosterone can contribute to or worsen ED. Treating hypogonadism alongside ED therapy often improves response to oral medications.
Peyronie’s Disease Treatment
Penile curvature from Peyronie’s disease can cause or worsen ED. Xiaflex injections (Dr. Lacy, Dr. Kim) and surgical correction are available for appropriate patients.
Common Questions
Frequently Asked Questions
Oral medications stopped working. What are my options?
Failure of oral medications does not mean you are out of options. Penile injection therapy is effective in many men who do not respond to PDE5 inhibitors. If injections are not desired or become less effective, a penile prosthesis is a highly satisfying long-term solution with patient satisfaction rates exceeding 90%.
I had prostate cancer surgery. Will I recover erectile function?
ED after radical prostatectomy is common but often improves over 12–24 months with nerve-sparing technique and penile rehabilitation. Early intervention — including oral medications and vacuum erection devices — supports recovery. For men with persistent post-prostatectomy ED, penile prosthesis offers excellent outcomes.
What is penile prosthesis surgery like?
A penile prosthesis (inflatable penile implant) is placed in an outpatient procedure under anesthesia. The device is entirely concealed inside the body. Recovery takes 4–6 weeks. Patient and partner satisfaction rates are consistently among the highest of any urologic procedure. See our erectile dysfunction page for more information.
ED Is Common. It’s Also Treatable.
From medication to surgical options, University Urology offers comprehensive ED evaluation and treatment with East Tennessee’s only fellowship-trained andrologist.