When talking about treatment options, we have to look at all of the reversible causes of Erectile Dysfunction. After careful consideration of Low T, Low Thyroid, High Cholesterol and Triglycerides, Diabetes, Blood pressure medications, Antidepressant medications, etc., urologists really only have five different types of treatments to offer to their patients.
During training, we are taught “goal-oriented therapy”, starting with the simplest treatment and progressing towards the relatively more complicated therapies. In this paradigm, a urologist may decide to avoid performing any diagnostic tests because the same five treatment options exist regardless of the test results.
In my practice, I have a different perspective, and I prefer to pursue “cause-oriented therapy”. In other words, I offer diagnostic testing in order to confirm the medical cause of the ED before I recommend any treatment options. In my experience, men want to know why they have ED before they accept any long term treatment options. On the contrary, when a patient has normal testing, it suggests the problem is psychological, prompting a referral to the sexual therapist in our office. This allows a patient to avoid any unnecessary treatments or surgery, and it usually cures the ED.
In conclusion, this cause-oriented approach allows me to advocate the best treatment option for each individual patient.