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Written and medically reviewed by Dr. Edward Gheiler, MD, FACS — July 26, 2026
Home › Erectile Dysfunction
Erectile Dysfunction Specialist in Miami: Treatment at Every Stage
ED is one of the most common conditions a urologist treats, and in most cases it can be treated. Whether you are just starting to notice a change or the pills have stopped working, there is a next step. Dr. Edward Gheiler treats every stage, in English and Spanish.
Treatment options at every stage
Erectile dysfunction is a medical condition, not an inevitability of age. Treatment follows a ladder, and the right rung depends on your health, your history, and what you have already tried:
- Lifestyle and underlying conditions. Weight, exercise, smoking, diabetes, and blood-pressure control all affect erections — and treating them helps.
- Oral medications. Sildenafil (Viagra), tadalafil (Cialis), and similar medications work well for many men, but not for everyone — and often less well over time.
- Injections and vacuum devices. Effective middle options when pills are not enough.
- The inflatable penile implant. For appropriately selected patients, the most consistently effective option when other treatments have failed: a concealed device that produces an erection on demand. Learn how the AMS 700 implant works.
Why ED deserves a real medical evaluation
The same blood-vessel changes that cause erection problems also occur in diabetes, high blood pressure, and heart disease. New or worsening ED can be the first sign of a condition worth catching early — which is why an evaluation with a board-certified urologist beats an online prescription. Dr. Gheiler identifies the cause, treats what can be treated, and tells you honestly what will and will not help. For a deeper look at causes and prevention, read our guide: What to know about erectile dysfunction.
When the pills stop working, you still have options
Many of Dr. Gheiler’s patients arrive after years on medications that gradually stopped helping — often after prostate surgery or with long-standing diabetes. For these men, the inflatable penile implant is, for appropriately selected patients, the most consistently effective option when other treatments have failed: placed through a single concealed scrotal incision using Dr. Gheiler’s Concealed-Scar Scrotal Technique™, typically in 15–20 minutes as outpatient surgery. He performs 400+ implant procedures a year and directs an implant surgical training program for other urologists. When medically necessary, the surgery is typically covered by insurance, including Medicare.
Why patients choose Dr. Gheiler for ED
Erectile dysfunction is one of the conditions Dr. Gheiler treats most, and part of his broader men’s sexual health practice. He has performed more than 8,000 prosthetic-urology cases and does 400+ inflatable penile implant procedures a year — and he directs an implant surgical training program that teaches the operation to other urologists. That experience matters most for the men at the end of the ladder, when medications have stopped working and the implant becomes the answer. See how long a modern implant lasts, or read our outcomes and safety approach.
Frequently asked questions
When should I see a doctor about erectile dysfunction?
If erection problems happen regularly for more than a few weeks, see a urologist. ED is common, treatment options exist at every stage — and it can also be an early signal of conditions worth catching, such as diabetes, high blood pressure, or heart disease.
What treatments are available for erectile dysfunction?
Treatment follows a ladder: lifestyle changes and managing underlying conditions, oral medications (sildenafil, tadalafil), injections and vacuum devices when pills are not enough, and the inflatable penile implant — for many men the most consistently effective option when other treatments have failed. Dr. Gheiler offers every rung of that ladder and helps you choose based on your case.
What if Viagra or Cialis stops working?
That is common over time, especially with diabetes or after prostate surgery. It does not mean nothing can be done. Injections work for some men, and the inflatable penile implant is the most consistently effective option when medications no longer work.
Is erectile dysfunction a sign of other health problems?
It can be. The same blood-vessel changes behind ED also occur in diabetes, high blood pressure, and heart disease — which is why new or worsening ED deserves a proper medical evaluation, not just a prescription.
Does insurance cover ED treatment?
Evaluation and most treatments are typically covered. When ED has a documented medical cause that has not responded to conservative treatment, Medicare and major commercial plans also cover inflatable penile implant surgery. The practice verifies individual coverage and handles prior authorization.
This page is patient education and does not replace a medical consultation. Individual results vary. Discuss your specific case with your urologist.
Talk to a urologist who treats ED every day
Confidential consultations in Hialeah, and virtual visits for out-of-area patients. English · Spanish · Hebrew.
Private and confidential from your first call: these are problems our office treats every day, with discretion and respect.
Call (305) 822-7227
