If Viagra doesn't work...

[Ratt19]

does that mean that all oral medications won't work as well?

First, thank you to the members and creator of this board, it has been invaluable in helping me understand an make decisions about my ED issues.

My doctor is refusing to let me try any other ED oral medications after Viagra failed to work for me. Furthermore, he is refusing to have a Penile Ultrasound
test done. He says that he has made his diagnoses of diabetes damaged tissue and blood vessels in my penis and he is recommending injection therapy.
Something feels wrong here. It feels like we haven' exhausted all of our options and we haven't proven that my penis is indeed damaged.

Anyone shed any light on this? From your experience, is the doctor right?

Either which way I am going for a second opinion.

Thanks

[bldoink]

Yeah, well either accept your doctor's diagnosis and plan of treatment of find another doctor. There's absolutely nothing wrong with getting a second opinion. A very good idea in many medical situations. A good doctor shouldn't be offended by a patient getting a second opinion.

However, whether your problem is diabetic damage or a venous leak, the treatment may well be the same. If pills don't work then usually shots are the next step. If shots don't work then an implant is the next step. The only other real option is a VED with rings. Even with a venous leak shots may work for a good while until the leak gets too bad for the meds to overcome it.

I don't really know how likely it is that if one of the pills doesn't work at all, another will work.

[Leebert]

I don't know if this helps with your decision,but I've went through all the pills, from the lowest strength to the big boy strength. The last time I used Cialis, which was my last one I could use, it did nothing. That was when I had to go to injections. Lot of guys fear them, so did I, but when I gave myself a shot for first time I hardly felt it. It's easier to do after each shot.

[Lost Sheep]

I used Sildenafil (Viagra) until it didn't work. Then switched to Cialis (can remember the generic name) and it worked for a while. Then Levitra and it worked for a while.

These worked for several years.

I skipped injections and suppositories altogether and got authorization for an implant. Used vacuum device in the meantime to maintain penile health.

I have not examined the question of whether or not I would have rather gone implant right off the bat rather than taking the pills, each in turn. But to answer your original question, your Doctor (in my not-so-humble lay opinion is wrong; the oral medications work in similar fashion, sure, but a little differently and where one is ineffective the others may well be). Perhaps he is taking a short-cut to what he believes is eventual reliance on the more invasive injections, or has some other reason why he thinks Cialis or Levitra are medically inadvisable. Absent medical reasons, there should be no harm in trying the other medications before the injections.

[dtwarren1942]

I have been a diabetic for 25 years. When Viagra stopped being effective, I tried Cialis which had only a slight effect - same as the Viagra. I then moved upto injections which worked for three to four years before they became ineffective

Your doc’s opinion is most likely correct; however, there is no good reason to not let you try another ED pill. There is a slight chance it will. Go for a second opinion.

[Quester]

First off I'm not a doctor so any advice I give is mine, and not a professional opinion. As a Pharmacy Technician I know that some medications work for some people and not others hence why we have so many medications in the same class.
That being said as a person who has gone from the over the counter products you know the ones that you see in the store. As we shouldn't endorse products but I tried Extenze and others that were supposed to help and they did for a while so maybe my ED is in my mind.

I then went to Viagra until all it was giving me was a wicked headache, during that time the VA I get my care from would switch back and forth from Viagra and Levitra so I tried them both. I'm not sure of Cialis about all I know of that one is that has a longer half life and you can take daily doses to be ready when the mood hits.

I opted not to try Muse (Alprostadil) Urethral Suppositories, since the Urologist that I saw said that he saw better results from injection. So I've been on CaverJect and Edex (alprostadil) injectors as again the VA would switch back and forth for my opinion I liked CaverJect better as I didn't have to worry about loosing the cartridge holder. But that is me.

After developing Peyronies Disease I still use Caverject as I love the hard I get from it but now I've decided to skip other treatments for PD and go with an implant.

[Ratt19]

You guys are amazing. Thank you so much for the answers. I know they aren't medical opinions, but they help. I have been having issues with my doctors original diagnoses of penile damage due to diabetes. The problem with urological medicine is that a lot of it is diagnoses based on opinion and not physical proof. My doctor finally admitted that I may not be damaged today. A big step in my opinion. It may not change my treatment, but at least he in entertaining the idea.

"It's possible you don't have physical damage to your penis. This is possible, although the rest of our history would argue against this."
Hope that helps,
REJ

[Lost Sheep]

You guys are amazing. Thank you so much for the answers. I know they aren't medical opinions, but they help. I have been having issues with my doctors original diagnoses of penile damage due to diabetes. The problem with urological medicine is that a lot of it is diagnoses based on opinion and not physical proof. My doctor finally admitted that I may not be damaged today. A big step in my opinion. It may not change my treatment, but at least he in entertaining the idea.

"It's possible you don't have physical damage to your penis. This is possible, although the rest of our history would argue against this."
Hope that helps,
REJ

My doctor is refusing to let me try any other ED oral medications after Viagra failed to work for me.

So, will he prescribe, say, a half-dozen doses of Cialis or Levitra for you to try? Sometimes pharmacy reps give out samples for Doctors to let their patients try.

He says that he has made his diagnoses of diabetes damaged tissue and blood vessels in my penis and he is recommending injection therapy.
Something feels wrong here. It feels like we haven' exhausted all of our options and we haven't proven that my penis is indeed damaged.

A doppler ultrasound should indicate if there are problems with arterial flow in or venous flow out of your erectile tissues. Is there a reason he has not investigated this?

Three different urologists recommended an implant for me based solely on my medical history, clinical examination and my verbal recounting of my history. No ultrasound was deemed necessary, nor other testing (like injecting alpostrodil or anything of the kind). We exhausted the oral medications, though over a period of years.

A broken bone with the limb flopping around is easy to diagnose. A non-working penis may be a little harder to diagnose than that, but not by much, I think, absent indications of any other possible causes.

Unless your doctor suspects another cause than damage (due to Diabetes or athersclerosis or whatever), I am inclined to think you have physical damage to your erectile function and (from what I know of available treatments) the available treatments are all equally applicable. That is, it makes no difference what the cause of your E.D. is, the treatments are all equally appropriate to whatever is ailing your penis. So, whichever works, you can use and diabetes does not rule out any of them. (oral meds, penile suppository, injections or implant). There are also external treatments, V.E.D, constriction ring, "splints" as well so you can accomplish coitus without an erection, per se.

None of these are cures, but the least invasive treatment that permits conjugal relations is the best thing to keep your life and psyche intact is needed until a true cure is found. That goes up to and including implant if that is what it takes.

[Ratt19]

I am still learning the boards. I am not sure how to do quotes.

Lost Sheep "So, will he prescribe, say, a half-dozen doses of Cialis or Levitra for you to try? Sometimes pharmacy reps give out samples for Doctors to let their patients try."

He says no. He says that "they all do the same thing. and if one fails then the others wouldn't work."

Lost Sheep "A doppler ultrasound should indicate if there are problems with arterial flow in or venous flow out of your erectile tissues. Is there a reason he has not investigated this?"

He says "To answer your questions, no, there would be no need for a penile ultrasound to confirm blood flow issues if your testosterone is normal. This is both because the decreased arterial flow is such a common causes of erectile dysfunction and because documenting that would not change management."

Lost Sheep "Unless your doctor suspects another cause than damage (due to Diabetes or atherosclerosis or whatever), I am inclined to think you have physical damage to your erectile function"

The doctor believes that poor diabetes management is the cause of my ED. I am diabetic.

[Robert66]

I started taking daflon 4 months ago and now i dont loose my errection when i sit down. Not the supplement which is same stuff but not micro ground