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Urology/Erection & Testostron Level,


Hi Dr.- I am 54 and I have been diagnose with ED about 10 tears ago and since then I have need taking either Viagra or Cialis with high success rate. From several months ago, I have discovered the that either Viagra or Ceilas has not much of impact and I am getting only a soft erection after taking PDE5 inhibitors. I have visited my urology and he believes the reason for soft erection is my low T level  of 250. He is recommending to use 10 pellets under skin therapy  to raise my T level. My question is do you believe that in my situation the low T is the main contributor to the soft erection and do you think is 10 pellets would be enough to raise my testosterone to range of 500?


In general, PDE5 inhibitors can become less effective as erectile dysfunction progresses.  When oral mediation at the maximum dose becomes ineffective, then it is reasonable to consider the alternative treatment options which may include testosterone supplementation (if low), a vacuum pump, MUSE (urethral suppository), injection therapy, or a penile implant.  The goal is to identify the least invasive and most acceptable option that is effective.  Testosterone supplementation may or may not improve your erections.   I do believe that other factors (e.g.. vascular) are often involved.  There is no way I can tell you if this treatment will be effective, but certainly, if you pursue this treatment, you will then get a more definitive answer.   Regarding dosage, I really can not tell you exactly what level will be achieved with a certain dosage.  A blood test will do that however.  Best of luck.


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Joel Gelman, M.D.


Urethral Stricture Disease, Peyronie's Disease and disorders of penile curvature, Erectile Dysfunction with a focus on penile implant surgery, Male Incontinence, Hypospadias


Dr. Gelman is a Board Certified Fellowship Trained expert in Male Reconstructive Urology and the Director of the Center for Reconstructive Urology in the Department of Urology at UC, Irvine Medical Center.

American Urologic Association Society of GU Reconstructive Surgeons (Board of Directors) International Sexual Medicine Society Western Section, Americal Urological Association

Journal of Urology Urology Journal of Endourology

Residency in Urology, UCLA, completed 1995 Fellowship in GU Reconstruction, Devine Center, completed 1997

Past/Present Clients
The Center for Reconstructive Urology is a regional, national, and international Tertiary Referral Center for urethral stricture disease, penile curvature, erectile dysfunction, male incontinence, and other surgical disorders of the male urethra and penis. Patients have travelled from 24 different states and other countries to receive care at the Center for Reconstructive Urology. More information can be found at

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