Ghatkopar (East), Mumbai)
Erectile Dysfunction
Erectile dysfunction is more common than most men realise - and far more treatable than most men believe. Yet it remains one of the least discussed health conditions, with the majority of affected men suffering in silence for years before seeking help. ED is not simply a sexual problem - it is often an early warning signal of cardiovascular disease, diabetes, or hormonal imbalance that deserves medical attention.
At Shree Hospitals, our urology and andrology team offers confidential, expert erectile dysfunction treatment in Mumbai, addressing both the symptom and its underlying cause.
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Our Approach
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Our Approach In Managing Erectile Dysfunction
Erectile dysfunction is a medical condition, not a character failing. Our approach treats it as such - beginning with a comprehensive evaluation to identify reversible causes, followed by a tailored treatment plan that respects each patient's medical profile, relationship context, and personal preferences.
- Confidential History & Psychosexual Assessment
Our consultation is confidential, structured, and non-judgmental:
- Duration, onset, and pattern of ED - gradual vs. sudden onset; situational vs. consistent
- Presence or absence of morning erections - helps distinguish psychogenic from organic causes
- Relationship and psychosexual history - performance anxiety, relationship conflict, past trauma
- Screening for depression, anxiety, and stress - major contributors to psychogenic ED
- Medication review - antihypertensives, antidepressants, and antiandrogens are common iatrogenic causes
- Cardiovascular & Metabolic Risk Assessment
ED is a recognised independent predictor of cardiovascular disease - often appearing 3–5 years before cardiac symptoms:
- Fasting glucose, HbA1c, and lipid profile - diabetes and dyslipidaemia are major ED risk factors
- Blood pressure and cardiac history review
- Testosterone (total and free), LH, FSH, and prolactin - to identify hypogonadism as a cause
- Referral to cardiology for patients with new-onset ED and cardiovascular risk factors
- Penile Blood Flow Assessment
For patients with suspected vascular cause or planning surgical treatment:
- Penile Doppler ultrasound following intracavernosal injection - assesses arterial inflow and venous leak
- Nocturnal penile tumescence (NPT) testing - distinguishes psychogenic from organic ED when needed
- Bulbocavernosus reflex and penile biothesiometry for neurogenic ED assessment
- Selective pudendal arteriography for pre-surgical vascular assessment in young trauma patients
- PDE5 Inhibitor Therapy - First-Line Treatment
Oral therapy with phosphodiesterase type 5 inhibitors is the most effective first-line treatment for most men:
- PDE5 inhibitor therapy - sildenafil (Viagra), tadalafil (Cialis daily or as-needed), vardenafil, avanafil
- Correct counselling on dosing, timing, and the need for sexual stimulation is essential
- On-demand vs. daily tadalafil - daily dosing rebuilds endothelial function and suits more frequent intimacy
- Dose optimisation - failure at a lower dose does not mean PDE5 inhibitor failure; titration is required
- Testosterone Replacement Therapy (TRT)
For men with confirmed hypogonadism contributing to ED or libido loss:
- Testosterone gel (daily topical) or injection (every 3 months) based on preference and compliance
- Baseline PSA, haematocrit, and liver function before initiating TRT
- Male sexual health treatment monitoring - repeat testosterone, PSA, and haematocrit at 3 and 6 months
- TRT combined with PDE5 inhibitor therapy for maximum benefit in hypogonadal men with ED
- Intracavernosal Injection & Vacuum Devices
For patients who do not respond to or cannot take PDE5 inhibitors:
- Intracavernosal injection (alprostadil, or bimix/trimix) - highly effective; produces erection within 5–15 minutes
- Patient self-injection training provided in clinic - technique supervised before home use
- Vacuum erection device - non-pharmacological option; creates erection by negative pressure; suitable for older men or post-prostatectomy
- Medicated urethral suppository (MUSE) - intraurethral alprostadil for patients unable to inject
- Penile Implant Surgery
The definitive, permanent solution for organic ED not responding to medical therapy:
- Penile implant surgery Mumbai - inflatable (3-piece hydraulic) or semi-rigid (malleable) prosthesis
- Inflatable implants provide the most natural erection and flaccid appearance - preferred by most patients
- Device entirely concealed within the body - activation by a small scrotal pump
- Patient satisfaction rates exceed 90% following inflatable penile prosthesis implantation
How To Identify Erectile Dysfunction?
ED is defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual activity. It is diagnosed clinically - based on symptoms and history:
Primary Symptoms:
- Difficulty achieving an erection from initial arousal - consistently or intermittently
- Inability to maintain an erection long enough for satisfactory intercourse
- Reduced firmness of erections - erections achieved but insufficient for penetration
- Loss of morning or spontaneous erections - suggests an organic (physical) rather than psychogenic cause
Associated Features That Suggest Underlying Cause:
- Recent diagnosis of diabetes, hypertension, or cardiovascular disease
- New medication - antihypertensives, antidepressants, or antiandrogens started before ED began
- Reduced libido alongside ED - suggests hypogonadism
- Depression or relationship difficulties - psychogenic contribution
- History of pelvic surgery, radiotherapy, or perineal trauma - neurogenic or vascular cause
ED that is sudden in onset, situational (occurs with one partner but not another), or associated with preserved morning erections is more likely psychogenic. Gradual, consistent, and progressive ED with absent morning erections is more likely to have an organic cause - and warrants medical investigation.
Treatments For Erectile Dysfunction At Shree Hospitals
PDE5 Inhibitor Therapy (Sildenafil / Tadalafil)
First-line oral medication - highly effective for most men with mild-to-moderate organic or psychogenic ED. Available as on-demand or daily formulations. Optimised dosing and counselling provided at Shree Hospitals.
Testosterone Replacement Therapy (TRT)
Injectable or topical testosterone for men with confirmed hypogonadism - restores libido, energy, and erectile function in combination with PDE5 inhibitor therapy where required.
Intracavernosal Injection Therapy
Direct injection of alprostadil (or combination therapy) into the penis - produces a reliable erection within minutes. Ideal for PDE5 inhibitor non-responders or men post-prostatectomy.
Vacuum Erection Device (VED)
Non-invasive device that creates an erection by negative pressure - safe for all men including those unable to take medication. Effective for post-prostatectomy or neurogenic ED.
Top Urologists in Mumbai
Dr. Shyam Mohan
Robotic Urological Surgery, Uro-Oncology
Dr. Alap Mehendale
Urologist, Andrologist, Kidney Transplant Surgeon
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Important FAQs: Erectile Dysfunction
Is erectile dysfunction a normal part of ageing?
While ED becomes more common with age, it is not an inevitable or untreatable consequence of ageing. It is a medical condition with identifiable causes - vascular, hormonal, neurogenic, or psychogenic - and highly effective treatments exist at every age. Men of any age experiencing persistent ED should seek evaluation rather than accepting it as a fixed condition.
Can lifestyle changes improve erectile dysfunction?
Absolutely. Regular aerobic exercise, smoking cessation, alcohol reduction, weight loss, and cardiovascular risk factor management have all demonstrated statistically significant improvements in erectile function. For men with mild-to-moderate ED driven by metabolic or cardiovascular risk factors, lifestyle modification alone can produce meaningful improvement - and enhances the effectiveness of PDE5 inhibitor therapy when medication is also required.
What is the success rate of penile implant surgery?
Penile implant surgery Mumbai - particularly inflatable prosthesis - has patient satisfaction rates consistently above 90% in published international studies. Partners also report high satisfaction. The device is entirely internal and invisible, provides a reliable on-demand erection with a simple squeeze of the scrotal pump, and does not affect orgasm, ejaculation, or sensation. It is considered the definitive solution for men with severe or medication-resistant ED.
Is erectile dysfunction always a sign of heart disease?
ED is a significant independent risk factor for cardiovascular disease - studies show that men with new-onset ED have a 2–3 fold higher risk of cardiac events compared to men without ED. This is because both share the same pathophysiology: endothelial dysfunction and impaired arterial blood flow. ED should prompt cardiovascular risk assessment - not because a heart attack is imminent, but because male sexual health treatment is an opportunity for early cardiovascular risk reduction.
Can ED medication be taken with blood pressure tablets?
PDE5 inhibitors should not be combined with nitrates (nitroglycerin, isosorbide) - the combination causes severe, potentially life-threatening hypotension. Most other antihypertensives can be used with PDE5 inhibitors, though alpha-blockers require careful dosing. Your urologist and cardiologist should both be aware of all medications before erectile dysfunction treatment in Mumbai is initiated. A comprehensive medication review is part of our initial assessment.
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