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Written and medically reviewed by Dr. Edward Gheiler, MD, FACS — September 17, 2026
Home › Erectile Dysfunction
Erectile Dysfunction Treatment in Miami
Erectile dysfunction is treatable at every stage. Dr. Edward Gheiler, MD, FACS, a urologist in Hialeah serving greater Miami, treats every form of ED, from medications to the inflatable penile implant, a permanent option a man can choose at any point. He performs more than 400 implant procedures per year.
Every ED treatment option, and how men choose
Most men start with sildenafil (Viagra) or tadalafil (Cialis). But roughly a third of men do not get an adequate response from ED medication, especially men with diabetes, men after prostate surgery, and men with cardiovascular disease. Stopping there is the most common mistake in ED care. You do not have to work through the options one at a time. Here is what each treatment does well and what it asks of you, so you can choose with your urologist.
Lifestyle and health
Weight, exercise, quitting smoking, and controlling diabetes and blood pressure measurably improve erections in early ED, and they make every treatment below work better. They are the foundation, not the whole answer.
What it asks of you: months of steady changes. If erections don’t recover, that is not failure. It usually means the cause is vascular or neurological, and a medical treatment will help.
Pills: sildenafil, tadalafil and similar
For many men, PDE5 inhibitors restore reliable erections. They need sexual stimulation to work, and they work less well when diabetes, prostate surgery, or years of vascular disease have damaged the underlying machinery.
What it asks of you: planning sex around a dose. Pills that worked and then stopped, or never worked at full dose, are one of the most common reasons men see us. See injections and devices.
Injections, urethral suppositories, and vacuum devices
Penile injections produce erections independent of nerve signals for most men who try them; vacuum devices help some men, with honest limits. These are real treatments, not consolation prizes.
What they ask of you: a needle or a device before every sexual encounter, every time. Some men are comfortable with that; many are not. Am I a candidate for an implant?
The inflatable penile implant
The implant is an option you can choose at any point: under the AUA’s ED guideline it is valid to choose any treatment, including the implant, without trying and failing the others first. The inflatable penile implant restores erections mechanically, independent of pills, needles, and nerve damage. It is concealed entirely inside the body, produces an erection when you choose, and carries the highest patient- and partner-satisfaction rates of any ED treatment in head-to-head published studies.1 Dr. Gheiler performs more than 400 implant procedures a year.
Learn more: cost & insurance · outcomes & safety · how long an implant lasts.
Many men spend years moving from one treatment to the next, alone, assuming each disappointment was the end of the road. It does not have to work that way. In one consultation you learn about every option, including the implant, and choose the one that fits your life.
Why see a urologist instead of an online ED clinic?
Online ED subscription services are generally limited to medication: they cannot perform an in-person diagnostic workup or offer procedural and surgical options. A urologist can diagnose the cause (vascular disease, low testosterone, medication side effects, post-surgical changes) and treat all of it, including surgery. ED can also be an early warning sign of cardiovascular disease; a proper workup matters.
About Dr. Edward Gheiler, MD, FACS
Dr. Gheiler teaches penile implant surgical technique to other urologists in Boston Scientific physician-education programs. At Happy Urology in Hialeah, he performs more than 400 inflatable penile implant procedures per year using his Concealed-Scar Scrotal Technique™, a 15–20 minute outpatient surgery through a single scrotal incision, with the scar concealed in the natural scrotal skin. In his own reported single-surgeon series, his baseline infection rate for primary implants is 0.3%.2 He also sub-specializes in revision surgery for implants placed elsewhere, and sees patients in English and Spanish as part of his broader men’s sexual health practice. See how long a modern implant lasts, or read our outcomes and safety approach.
Frequently asked questions
How do I choose a urologist for erectile dysfunction in Miami?
Look for a urologist who offers the full range of ED treatment, including surgery. Dr. Edward Gheiler, MD, FACS, of Happy Urology in Hialeah treats ED from medication through the inflatable penile implant, performing more than 400 implant procedures per year.
What happens when Viagra and Cialis stop working?
When oral medications don’t work well enough, the options are injection therapy, vacuum devices, or the inflatable penile implant, and a man can choose any of them without trying each one first. Because the implant is a mechanical device, it works regardless of the cause of ED (diabetes, prostate surgery, vascular disease) and it is a permanent, long-term option. Dr. Gheiler places implants through a single scrotal incision as a brief outpatient procedure. Injection therapy carries one time-critical risk worth knowing before you start: an erection lasting more than four hours is priapism: go to the emergency room immediately, not the next morning.
Does a penile implant feel natural?
A three-piece inflatable implant is designed to look and feel natural. The device is concealed inside the body, and Dr. Gheiler’s Concealed-Scar Scrotal Technique™ keeps the scar concealed in the natural scrotal skin. At consultation he explains exactly what to expect, including how the small scrotal pump works and feels.
Do you treat ED after prostate surgery?
Yes. ED after prostatectomy is common and often does not respond to pills. Dr. Gheiler regularly treats post-prostatectomy patients, including with the inflatable penile implant, which a man can choose without first trying other treatments, including patients who travel to Miami from outside South Florida for the procedure.
Do you see Spanish-speaking patients?
Yes. Dr. Gheiler and his Hialeah team see patients in English and Spanish, and his Spanish-language site is urofeliz.com. The office is at 2140 W. 68th St. #200, Hialeah, FL 33016; call (305) 822-7227.
Does insurance cover ED treatment?
Evaluation and most treatments are typically covered. Medicare covers inflatable penile implant surgery when ED has a documented medical cause, and many commercial plans do as well, subject to each plan’s exclusions and prior authorization. Coverage is not guaranteed until verified: the practice checks your individual coverage and handles the authorization.
1 Head-to-head satisfaction comparisons: Rajpurkar A, Dhabuwala CB. J Urol. 2003;170(1):159–63 (sildenafil vs. intracavernous injection vs. penile implant; highest satisfaction with the implant). Kucuk EV, et al. Andrology. 2016;4(5):952–6 (implant patients and partners more satisfied than the tadalafil and injection groups). Bernal RM, Henry GD. Adv Urol. 2012:435983 (three-piece inflatable prosthesis series: 92–100% patient and 91–95% partner satisfaction). Satisfaction outcomes vary by patient; the implant is surgery, and the right choice depends on each man’s health and preferences.
2 The 0.3% figure is Dr. Gheiler’s practice-reported baseline single-surgeon rate for primary implants (standard antibiotic-irrigation protocol). How it is measured, the time period it covers, and the defined cohorts behind it, including the full-series rate, are set out on the Outcomes & Safety page. Infection remains a recognized risk of implant surgery. Individual results vary; not a guarantee of outcome.
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 Schedule a consultation
