Breaking the Silence: How Open Dialogue, Early Intervention and Shared Decision-Making Can Make an Impact in Solving Erectile Dysfunction

When Lawrence consulted Dr. Shawn Blick for a urology concern, he had no idea that this visit would change his life. After experiencing Dr. Blick's expertise firsthand, Lawrence found the courage to open up about his isolation and shame caused by years suffering from Erectile Dysfunction (ED). Through extensive counseling, Dr. Blick introduced Lawrence to a treatment option he had never considered before - a penile implant. Dr. Blick guided Lawrence through the procedure and recovery, leaving him with only one regret: not disclosing his concerns with a urologist sooner.

Lawrence's story is just one among many shared in the HARD docuseries which sheds a light on the emotional and physical impact of ED.

Erectile dysfunction, defined as the persistent inability to achieve or maintain a firm erection for sexual intercourse,^[1] is a widespread condition affecting millions of people worldwide, including a significant number in Europe. According to a report from the European Commission^[2], the most severe forms of erectile dysfunction are reported by 5% to 16% of the male population in the 34 countries surveyed (including 27 EU Member States, 4 EFTA countries and 3 candidate countries), which equates to between 14 million and 46 million men.

Although it is not life-threatening, the burden of ED on a patient’s quality of life is substantial.^[3],[4] It is associated with psychosocial problems such as anxiety, depression, anger, frustration, poor self-esteem, guilt, lack of sexual confidence and limited intimacy.^[5],[6] Additionally, it impacts partners and employers due to relationship difficulties,^[7],[8]  increased absenteeism and reduced productivity.^[9]

Treatment options

The good news is that there are various therapeutic options to treat ED. It is first advisable to make lifestyle adjustments and address risk factors before or alongside commencing ED treatment.^[10],[11] The primary recommended first-line treatment is an oral phosphodiesterase-5 inhibitor (PDE5I).^[12] Other alternatives consist of vasoactive drug self-injections, intraurethral suppositories, vacuum erection devices, and penile implants.^[13]

Penile implants are medical devices surgically inserted into the penis, enabling the person to achieve an erection suitable for sexual intercourse. They offer concealed support for an erection whenever and wherever desired, helping people regain their confidence and sense of normalcy in their intimate lives.^[14],[15] For 50 years, urologists have been restoring sexual function and intimacy with the help of penile implants for more than half a million patients worldwide,^[16],[17] providing patients and their partners high overall satisfaction.^[18]

Patient preferences

Until 2019, the European Association of Urology (EAU) guidelines recommended penile prosthesis implantation as a third-line therapy,^[19] meaning it was considered after other treatments had failed to produce satisfactory results. However, the EAU’s current guidelines recommend implantation “if other treatments fail or depending on the patient’s preference.”^[20]

This move to include patient preference as a criteria for penile prosthesis implantation, is indicative of a wider reorientation towards a more patient-centered approach, as confirmed by a recent study revealing that most implanted patients surveyed expressed a desire for earlier intervention.^[21]

Lawrence’s regret of not disclosing his concerns sooner with a urologist aligns with these findings. 

In line with the scientific community's move towards a more individualised approach to treatment decision-making, the HARD docuseries showcases four men from diverse backgrounds, demographics, and geography, each sharing their unique experiences with ED. By candidly documenting the physical and emotional impact of ED, HARD aims to reduce the stigma surrounding the condition and provide hope for those seeking to restore their sexual health.

Spotlight on Men’s Health

This article is released during Men's Health Month, during which Boston Scientific is raising awareness about ED and collaborating with physicians to help the millions of people like Lawrence silently suffering from this condition.

Join us in the HARD fight to solve erectile dysfunction:  https://www.edtreatments.com/resources/real-stories.html