【Urological Methods to Enhance Erectile Function】

First-Line Treatment: Oral Medications
The first-line therapy for improving erectile function involves oral medications—most commonly phosphodiesterase type 5 inhibitors (PDE5 inhibitors), such as Viagra, Cialis, and Levitra.
These drugs are classified into short-acting and long-acting types depending on their half-life. After discussing personal health conditions with a urologist, patients can choose short-acting medications taken before sexual activity, or long-acting medications taken daily to maintain consistent efficacy.
However, individuals taking nitrate medications for cardiovascular conditions must avoid PDE5 inhibitors, as the combination can cause dangerously low blood pressure or even shock. Therefore, consultation with a physician before use is essential.

Second-Line Treatment: Local Therapy with Prostaglandin and Vacuum Devices
The second-line treatment for erectile dysfunction involves the local administration of prostaglandin, often used in combination with a vacuum erection device. Prostaglandin can be delivered through the urethra or directly injected into the corpus cavernosum.
In Taiwan, for patients whose response to oral medications is inadequate, urologists can instruct them on how to self-administer intracavernosal injections of prostaglandin prior to sexual activity.
 

Third-Line Treatment: Penile Implant Surgery
The third-line treatment involves the implantation of a penile prosthesis. There are different types of prostheses—some are simple, one-piece models that can be manually bent up or down, while others are more advanced two-piece or three-piece designs.
During surgery, the urologist places a fluid reservoir behind the pubic bone and implants the inflatable cylinders into the corpus cavernosum, connecting the components via internal tubing.
 

Regenerative Medicine Approaches
In addition to established treatments such as medication, vacuum devices, and penile implants, recent years have seen growing interest among urologists and andrologists in regenerative medicine.
Currently, international medical associations recognize low-energy penile shock wave therapy (also known as linear or focused shock wave therapy) as an effective non-invasive option. The procedure typically involves six painless, non-invasive sessions lasting about fifteen minutes each. The therapy promotes angiogenesis (new blood vessel formation) and tissue regeneration in the penile corpus cavernosum.

Researchers in andrology continue to explore Platelet-Rich Plasma (PRP) therapy, which utilizes the patient’s own blood enriched with growth factors, and stem cell therapy, aiming to help more mature men regain confidence and enjoy a fulfilling intimate life.