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

Jun 6, 2023

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

 

[1] https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/all-content National Kidney and Urologic Diseases Information Clearinghouse Web site. Downloaded June 15, 2023.

[2] European Commission. The State of Men’s Health in Europe. 2011. https://ec.europa.eu/health/sites/default/files/state/docs/men_health_extended_en.pdf. Accessed August 3, 2021.

[3] Van Renterghem, K., et al. Majority of erectile dysfunction patients would have preferred earlier implantation of their penile prosthesis: validation of the recently changed EAU guidelines. Int J Impot Res (2022).

[4] Guest JF, Gupta RD. Health-related quality of life in a UK-based population of men with erectile dysfunction. Pharmacoeconomics. 2002;20(2):109-17.

[5] See note 4

[6] Elterman DS, Bhattacharyya SK, Mafilios M, Woodward E, Nitschelm K, Burnett AL. The Quality of Life and Economic Burden of Erectile Dysfunction. Res Rep Urol. 2021 Feb 18;13:79-86.

[7] See note 4

[8] Wagner G, Fugl-Meyer KS, Fugl-Meyer AR. Impact of erectile dysfunction on quality of life: patient and partner perspectives. Int J Impot Res. 2000;Oct;12 Suppl 4:S144-6.

[9] Goldstein I, Goren A, Li V.W. The association of erectile dysfunction with productivity and absenteeism in eight countries globally. Int J Clin Pract. 2019;00:e13384

[10] Salonia A, Bettocchi C, Boeri L, Capogrosso P, Carvalho J, Cilesiz NC, et al. European Association of Urology Guidelines on sexual and reproductive health-2021 update: male sexual dysfunction. Eur Urol. 2021;80:333–57.

[11] See note 3

[12] See note 9

[13] Mayo Clinic. (2021). Erectile dysfunction: Treatments and drugs. https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/diagnosis-treatment/drc-20355782

[14] Data on file with Boston Scientific.

[15] Otero JR, Cruz CR, Gómez BG, et al. Comparison of the patient and partner satisfaction with 700CX and Titan penile prostheses. Asian J Androl. 2017 May-Jun;19(3):321-325.

[16] Scott FB, Bradley WE, Timm GW. Management of erectile impotence: use of implantable inflatable prosthesis. Urology. 1973 Jul;2(1):80-2.

[17] See note 14

[18] See note 15

[19] Hatzimouratidis K, Giuliano F, Moncada I, et al. EAU Guidelines on Sexual and Reproductive Health. EAU Guidelines. Edn. Presented at the EAU Annual Congress Copenhagen 2018. ISBN 978-90-79754-91-5.

[20] See note 9

[21] See note 3

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