Men's health · ED
Erectile dysfunction is worth a proper evaluation.
Erection problems are a frequent reason men come to see us, and they can be the first visible sign of a blood-vessel or blood-sugar problem such as heart disease or diabetes.
The evaluation
It starts with your medical and sexual history and an exam, and often blood tests for glucose, cholesterol and hormones. Some men need a penile ultrasound to look at blood flow. Both history and basic testing happen in the office.
02Treatment options
Choices our urologists discuss range from daily or on-demand PDE5 tablets and vacuum devices to shockwave therapy at low intensity, penile injections taught by a provider, and pelvic floor exercises. Managing blood pressure, diabetes, weight, alcohol and smoking also matters.
03Related
Low testosterone can be assessed at the same time. Low T. When curvature and erection trouble occur together, see Peyronie’s disease.
What erectile dysfunction is, and why we evaluate it rather than guess
Erectile dysfunction means it has become difficult to get or keep an erection firm enough for sex. It can have vascular, hormonal, medication-related, or emotional contributors, and often more than one is in play. Our urologists can help if this has been happening more than occasionally, or if it arrived along with other changes such as a weaker stream or lower energy.
A visit at the Johns Creek Clinic & Surgery Center, 10730 Medlock Bridge Rd, or at the Cumming Clinic, starts with a medical and sexual history, a focused exam, and laboratory tests when those results would change the plan. Nighttime erection testing or imaging is used in selected cases, not as a default for every person.
ED treatments our urologists offer
Our urologists offer PDE5 medicines such as sildenafil and tadalafil, lifestyle measures that support blood-vessel health, testosterone replacement when labs show a deficiency, injections into the penis such as alprostadil, low-intensity shockwave therapy in a series of brief office sessions, and a penile implant — inflatable or malleable — when other options have not been enough or cannot be used. Each has risks. We will not start with the most involved option if a simpler one still has a genuine chance to help.
When to call, and how to prepare
You can phone 678-344-8900 or reserve a time online when the problem is persistent, when a medicine you already tried has disappointed you, or when you want a urologic evaluation rather than a short online questionnaire. This is not an emergency in the usual sense; chest pain, however, is, and belongs in emergency care.
Write down the medicines you take, including heart medicines, and any pills you have already tried for erections. Bring identification, your insurance card, and that list. Dr. Herman Bagga, who discusses ED in an official practice video below, sees patients at the Cumming Clinic; Johns Creek visits are with Dr. Neal Patel, Dr. T. Casey McCullough, Dr. Nicholas Farber, or a physician assistant on that team.
Do I have to try a pill before we talk about other options?
Not if a pill is a poor fit for your health, and not if you have already given one a fair try. We will still ask what you have used so we are not repeating a failed step.
Is shockwave therapy something this practice actually offers?
Yes. Our erectile-dysfunction page describes low-intensity shockwave therapy as an in-office treatment that uses acoustic waves. Whether it belongs in your plan is a decision for the visit.
Will the conversation be matter-of-fact?
Yes. This is routine urology for us, and we will talk about it the way we talk about any other function that is not working as you want it to.
Official ED conversations, including one with a Cumming Clinic urologist
Dr. Herman Bagga, who practices at our Cumming Clinic, hosts an official video session on erectile dysfunction from Advanced Urology. Two other official-channel videos review causes and treatments, including a talk by Dr. Chirag Dave, who is part of the wider practice. They are education, not a prescription.
Watch: Erectile Dysfunction webinar with Atlanta Urologist Dr. Herman BaggaWhat the video covers. Titled "Erectile Dysfunction webinar with Atlanta Urologist Dr. Herman Bagga." The public description covers erectile dysfunction, including causes, symptoms, and treatments, featuring Dr. Herman Bagga.
Watch: #007 - Breaking Down Erectile Dysfunction: Causes, Treatments, and New AdvancesWhat the video covers. Titled "#007 - Breaking Down Erectile Dysfunction: Causes, Treatments, and New Advances." The public description covers causes, diagnosis, and treatment options for erectile dysfunction, including lifestyle changes and oral medication.
Watch: Erectile Dysfunction (ED) Treatment Options Presented by Dr. Chirag DaveWhat the video covers. Titled "Erectile Dysfunction (ED) Treatment Options Presented by Dr. Chirag Dave." The public description states that erectile dysfunction is estimated to affect over half of men aged 40 to 70, and covers treatment options ranging from prescription medication to penile implants.
Can an erectile dysfunction visit start in Cumming?
Yes. Evaluation can begin at either office. Procedures, when they are recommended, are scheduled at Johns Creek.
What should I bring?
A medicine list, including heart medicines, and any prior hormone or blood-sugar results you have. The packing-list page on this site has the rest.
Do you also check testosterone?
When it would change the plan, yes. Our low testosterone page explains how we confirm a low level before talking about replacement.
Is this an emergency?
An erection lasting hours, or sudden pain after an injury, belongs in emergency care. Ongoing erection difficulty is clinic work.
Whenever a visit would help, the Johns Creek and Cumming teams are a phone call or a booked appointment away.