Behandlung von erektiler Dysfunktion in Bangkok

Behandlung von erektiler Dysfunktion in Bangkok

Comprehensive, evidence-based care for men experiencing erectile dysfunction (ED) — from oral medications to advanced surgical options — delivered with complete discretion at Bangkok Hospital Headquarters.

Medizinisch überprüft von Dr. Soarawee Weerasopone, MD – Fachärztin für Urologie · Wissenschaftliche Mitarbeiterin & klinische Beobachterin, Scott Department of Urology, Baylor College of Medicine

What Is Erectile Dysfunction?

Erectile dysfunction (ED) is the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual activity. Population studies put it at roughly 10–16% of men under 40 and more than half of men over 60 — yet it remains significantly underdiagnosed because of stigma.

ED is more than a sexual health issue. It is often the earliest clinical manifestation of cardiovascular disease, diabetes, or hormonal imbalance. Modern urological evaluation can both restore sexual function and identify underlying systemic conditions before they become life-threatening. Explore the 4 pillars behind ED → Dr. Soarawee also explains the mechanisms, causes, and treatment of ED in depth in his Bangkok Hospital article on erectile dysfunction →

Common Causes of ED

• Vascular causes — arterial insufficiency, venous leak, atherosclerosis
• Metabolic causes — diabetes, obesity, obstructive sleep apnea, metabolic syndrome
• Hormonal causes — low testosterone (hypogonadism), thyroid disorders
• Neurogenic causes — nerve damage, spinal injury, post-prostatectomy
• Psychogenic causes — anxiety, depression, relationship stress
• Medication-induced — antihypertensives, antidepressants, prostate medications
• Lifestyle factors — smoking, alcohol, sedentary behavior

One point worth making before the treatment ladder below: if a medication you take is the likely cause, do not stop it yourself. Several of the drugs on that list are dangerous to stop abruptly, and there is usually an alternative that can be substituted under supervision.

Behandlungsmöglichkeiten

Following evidence-based treatment escalation pathways from the American Urological Association (AUA) and the European Association of Urology (EAU) guidelines.

Level 1 — Oral Therapy

PDE5 inhibitors (sildenafil, tadalafil, vardenafil, avanafil) remain first-line therapy and work well for the majority of men. This includes daily low-dose tadalafil for men who have both ED and benign prostatic hyperplasia (BPH). They are not suitable for everyone, in particular men taking nitrates. How tadalafil improves ED →

The nitrate interaction is the one absolute rule here. Taking a PDE5 inhibitor together with a nitrate — including a glyceryl trinitrate spray or tablet used for chest pain, and the amyl nitrite sold as poppers — can cause a catastrophic fall in blood pressure. If you have ever been prescribed a nitrate, say so before any prescription is written, and if you develop chest pain after taking a PDE5 inhibitor, tell the emergency team which drug you took and when.

Level 2 — Non-Invasive

• Low-Intensity Shockwave Therapy (LI-ESWT) — aims to improve blood supply in vasculogenic ED. How LI-ESWT works →
• Vacuum Erection Device (VED) — a mechanical option, particularly useful during recovery after prostate surgery

MUSE (the intra-urethral alprostadil suppository) is not available at Bangkok Hospital Headquarters. Where an injectable is appropriate, intracavernosal therapy is used instead.

Level 3 — Intracavernosal Injection (ICI)

Injection therapy delivered directly into the erectile tissue produces a reliable erection in most men, including many who do not respond to tablets. The first dose is always given in the clinic so that the response and the correct dose can be judged safely, and patients are then taught self-administration. The main risks that are discussed beforehand are pain at the injection site, bruising, scarring with long-term use, and — rarely but importantly — a prolonged erection, which requires urgent medical attention if it lasts beyond four hours.

That last point deserves emphasis rather than a footnote. An erection lasting more than four hours is priapism, and it is a genuine emergency: after roughly that long the trapped blood starves the tissue of oxygen, and delay can cause permanent loss of erectile function. Go to an emergency department — do not wait until morning, and do not try to resolve it at home.

Level 4 — Inflatable Penile Prosthesis (IPP)

A definitive surgical solution for men who do not respond to conservative therapy or who prefer a permanent, on-demand result. Three-piece inflatable devices have consistently high satisfaction in published series; as an implant, infection and the possibility of revision surgery later are part of the discussion before proceeding. One thing to understand before consenting: implantation removes the natural erectile tissue, so it is not reversible — if the device is ever removed, the earlier treatments no longer work. Learn more about IPP →

Häufig gestellte Fragen (FAQ)

Q1: Is erectile dysfunction treatable?

Almost always, yes. It is worth separating two ideas: some causes can be reversed — low testosterone, a medication side effect, poorly controlled diabetes, heavy smoking — while others are managed rather than cured. Either way, the great majority of men reach a satisfactory result at some level of the treatment ladder, provided the underlying cause is identified first rather than a prescription being issued blind.

Q2: When should I see a urologist for ED?

Consult a urologist if you experience consistent difficulty achieving or maintaining an erection for more than 3 months, especially if you are under 50 — vascular ED in young men may be the earliest sign of cardiovascular disease and warrants prompt evaluation. See lifestyle strategies to prevent ED →

Q3: Are PDE5 inhibitors safe long-term?

Sildenafil, tadalafil and the other PDE5 inhibitors have an excellent long-term safety record when prescribed by a qualified physician. They are contraindicated in patients taking nitrates — including glyceryl trinitrate for chest pain and the amyl nitrite sold as poppers — because the combination can cause a dangerous fall in blood pressure, and they require caution in severe cardiovascular disease. Self-medication without medical evaluation is strongly discouraged, and medicines bought online are a common source of counterfeit product.

Q4: What is Penile Duplex Ultrasound and do I need it?

Penile Duplex Ultrasound (PDU) is a specialized vascular study that assesses blood flow to the penis. It distinguishes arterial insufficiency from venous leak — critical information for selecting the right treatment. It involves an injection into the erectile tissue to mimic arousal, after which the imaging is performed by a radiologist with Dr. Soarawee present. PDU is particularly valuable for men under 50 with ED, men who failed oral therapy, or those considering surgical treatment. It is not needed in every case.

Q5: An erection that will not go down — is that an emergency?

Yes. An erection lasting more than four hours is priapism and needs an emergency department, not a morning appointment. The trapped blood becomes starved of oxygen, and beyond a few hours the damage to the erectile tissue can be permanent. It is an uncommon but recognised risk of injection therapy, and can also occur with certain medications and blood disorders. Tell the emergency team exactly what you took and when.

Q6: Does insurance cover ED treatment in Thailand?

Insurance coverage varies by provider and policy. Some Thai insurance policies cover diagnostic evaluation when ED is associated with underlying medical conditions such as diabetes or cardiovascular disease. International insurance often covers consultation and prescription medications. Coverage and cost questions are handled by the hospital rather than by Dr. Soarawee — email the Urology department at bhquro@bdms.co.th or contact Bangkok Hospital’s international patient services.

Q7: How do I arrange a consultation with Dr. Soarawee?

All appointments are arranged exclusively through Bangkok Hospital’s official booking system, or for the Chonburi clinic through the Samitivej Sriracha department line 088-022-1445. Dr. Soarawee does not provide medical assessment, advice, diagnosis or prescriptions through personal messaging channels or social media. International patients travelling to Bangkok can contact Bangkok Hospital’s International Patient Services, who assist with scheduling, transfer of previous medical records, and coordination of the visit before arrival.

Q8: Can I discuss this by video consultation first?

Yes, and for a subject many men find hard to raise, it is often the easier way to start. Bangkok Hospital operates a Telemedicine service and Dr. Soarawee sees patients through it; arrange it in advance by email to the Urology department at bhquro@bdms.co.th. A video consultation suits history-taking, reviewing previous blood results and current medication, and deciding what testing is actually worth doing. Physical examination, blood tests and penile duplex ultrasound require an in-person visit. Samitivej Sriracha Hospital does not offer telemedicine and is in-person only.

Q9: What makes Bangkok a destination for ED treatment?

Thailand offers urological care at internationally accredited hospitals (JCI), with the same diagnostic and surgical technology used in leading centres elsewhere, and with English-speaking staff and genuine privacy for a sensitive condition. For what any part of it costs, email the Urology department at bhquro@bdms.co.th; prices are quoted by the hospital, not by Dr. Soarawee.

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All consultations are conducted with complete discretion and privacy.

Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients — arrange it in advance by email to the Urology department at bhquro@bdms.co.th. Samitivej Sriracha is in-person only.

Medical disclaimer: The information on this page is provided for general educational purposes only. It is not medical advice, does not address any individual case, and is not a substitute for consultation with a qualified physician. An erection lasting more than four hours is a medical emergency and needs immediate hospital care. Medical advice, diagnosis and prescriptions are not provided through personal messaging channels or social media. Reading this page does not create a doctor–patient relationship. Please seek in-person medical evaluation for any personal health concern.