Q: My husband likes the option of treating erectile dysfunction with a pill because of the simplicity, but would that be dangerous after a coronary stent placement several months ago?
A: Viagra, Cialis, and Levitra are PDE5 inhibitors that work by dilating blood vessels to increase penile blood flow. They are safe and effective but can cause a dangerous drop in blood pressure if taken with medicines called nitrates. Specifically, men with unstable angina and those prescribed nitrates should not take PDE5 inhibitors. Be assured that many cardiac patients are fine to take PDE5 inhibitors, including men with mild coronary artery disease without angina and those men successfully revascularized with a bypass graft or coronary stent.
Q: My physician detected prostate cancer during a routine PSA screening, and I am undergoing treatment. If my treatment results in erectile dysfunction, can it be successfully managed?
A: Fortunately, the newest prostate cancer treatments such as robotic surgery or radiation therapy will allow most potent men to maintain or return to sexual activity. While patients have individual medical issues and preferences, most men can successfully treat erectile dysfunction. Your urologist will review the possible treatment options such as oral medication, vacuum devices, intraurethral suppositories and placement of an inflatable penile prosthesis, and will work with you to find the most effective treatment.