When erections become unreliable, it’s not just a physical change; it’s a relational one. Both partners can lose confidence, and intimacy can quietly slip away.
As urologists, we often focus on function, restoring blood flow, prescribing PDE5 inhibitors, and recommending vacuum pumps. But what if we also focused on helping couples rebuild desire?
Beyond Performance
For many men, an erection feels like proof of masculinity. When it’s lost, after prostate surgery, medication, or simply with age, it can trigger shame and avoidance. Their partners, unsure how to respond, may withdraw too.
But intimacy doesn’t have to end when erections do. It can be relearned if we help patients shift from performance to connection.
Tools that Support Both Recovery and Pleasure
Devices like Medivibe, which can be used from a flaccid state, are changing how we think about recovery.
They stimulate blood flow, help preserve erectile tissue, and, crucially, enable couples to stay sexually connected while the body heals.
When used together, these devices turn “rehab” into something sensual and shared, reducing anxiety and reigniting desire.
Our Role as Clinicians
We can make a real difference simply by starting the conversation.
Normalise pleasure. Introduce intimacy tools early. Encourage partners to explore touch and play without pressure for penetration. From penetrative performance to mutual pleasure and connection can be transformative. It reintroduces curiosity, touch, and communication, and reduces the pressure that often inhibits arousal.
Devices that Support Recovery and Connection
Physiological recovery and intimacy can, and should, progress hand in hand. Devices such as Medivibe (a medical-grade vibro-stimulation device that can be used from a flaccid state) offer dual benefits:
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Physiological – Regular vibration therapy can stimulate blood flow, promote endothelial health, and help preserve erectile tissue post-surgery or during prolonged ED.
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Psychological and Relational - When used with a partner, such devices can reintroduce sensuality and reduce anxiety around penetration or erection quality.
By integrating these tools into rehabilitation plans, clinicians can normalise sexual play as part of recovery, not a taboo topic reserved for later.
The Role of the Urologist: Enabling Dialogue
Many patients and their partners are unsure how to start conversations about sex after ED. Clinicians can help by:
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Initiating the discussion early: Address intimacy as part of the treatment plan, not an optional afterthought.
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Framing devices and aids as positive interventions: Present them as tools for sexual health and tissue preservation, not signs of failure.
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Encouraging joint consultation: Inviting partners into the discussion often reduces shame and opens pathways for shared exploration.
Towards a Broader Definition of Recovery
Erectile function is one measure of success: but sexual wellbeing encompasses far more. When couples learn to experience desire and pleasure without the binary of “working” or “not working,” they often report renewed emotional closeness and reduced performance anxiety.
As urologists and sexual medicine professionals, we have an opportunity to lead this reframing: from restoring erections to restoring confidence, communication, and intimacy.