Erectile dysfunction (ED), also know as impotence, can be caused by various lifestyle issues such as obesity, cigarette smoking, alcohol consumption, drug abuse, depression, anxiety and many others.

Conditions such as prostate surgery, diabetes and heart disease are also very well known causes of erectile dysfunction. Erectile dysfunction is treatable in all these conditions.

There are obviously different physiological reasons for erectile dysfunction, depending on your diagnosis, but the consequence to you is the same: An inability to achieve a good, strong erection. We understand how this can impact on your life and relationships.

Regardless of any treatment you may have tried before take a few minutes and read further. If you feel this is relevant to you,  call Robert and have a chat with him about your circumstances  Almost all erectile dysfunction is treatable. Our personal percentage of success is 97 per cent.


Surgery involving the prostate will always cause erectile dysfunction and sometimes, urinary incontinence and bowel problems.

When you have had the devastating diagnosis of Prostate Cancer you will be given some choices of watch and wait with regular PSA blood tests or if appropriate, surgery or radiotherapy will be discussed

Your Surgeon or Oncologist should help you with this. Depending on your age at surgery and any pre-existing conditions, it may take some weeks or months to regain normal bladder function. Erections will always be affected in the short term and often may need ongoing treatment.

With radiotherapy you may suffer Erectile Dysfunction some considerable time after treatment has finished. Sometimes post op. erectile issues are not dealt with at all well.

MES has been involved with the care of post prostate surgery men since starting the clinic 14 years ago and have many patients referred to us by their Urologist for this important issue.

Like all areas of medicine and any other professions, not all practitioners are expert in all aspects of their chosen field. If you feel that maybe this is the case for you, then a second opinion should be sought. Most men can be helped!

Please note:

In some cases, despite the best surgical expertise and nerve-sparing surgery, erections don’t return at all or are not sufficient for penetrative sex. These issues can be treated but need to be treated aggressively and as soon as possible post operation. This is where the process of penile rehabilitation takes over.

Diabetes is a slowly evolving condition. Sometimes erections are the first thing to misbehave with a gradual weakening of erectile strength.

If ignored, this will only get worse, until you are unable to get an erection at all.

If your erection has already weakened, you need to see your GP and work with them to improve your diabetic management if possible. You also need to have heart screening such as a Thallium Cardiac Stress test or stress Echo-Cardiogram.

In early diabetes, Viagra, Cialis or Levitra are a great help. They will lose their effects if you continue to have high blood sugar. High blood sugars damage blood vessels but can also affect nerves; both of which are vital in normal erections.

Looking after your diabetes will prevent this in most cases. Some men do have, through no fault of their own, difficulty in maintaining good blood sugar levels despite good medical help. Some have had undiagnosed diabetes for some time.

We can help you now, but you need to be vigilant in the management of your diabetes to prevent further deterioration to the point where we cannot help.

If you have had a heart attack or suffer with Angina when you exercise you have what is loosely called Heart Disease. The effect of ‘Heart Disease’ on blood vessels is to narrow them with plaque where some can eventually cause thrombosis (clot) to block the artery.

In the penis the same process slows and interferes with the blood supply to the penis. In some cases erections are totally lost.

Cialis, Viagra or Levitra tablets are used as a first line treatment. These help to make it easier to achieve an erection. If you have Angina and are on Nitrate medication ( Glyceryl Trinitrate or GTN) whether spray, patch or under the tongue you cannot use these tablets.

Do not be tempted by supplements or ‘cures’ advertised on the internet. They can be very dangerous as well as a waste of money.

If the tablets are unsafe for you or they just don’t work, we will help you with the next line of treatment.