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b'Erectile dysfunction is a common problem that is generally treated with a three-tiered approach, says Upstate urologist Erectile dysfunction is a common problem that is generally treated with a three-tiered approach, says Upstate urologist JC Trussell, MD JC Trussell, MD. Erectile dysfunction is the persistent inability to achieve or maintain a penile erection for satisfactory sexual performance, Trussell says, and it\'s an issue for more men as they get older. He describes the types of ED, contributing factors including stress, diabetes and heart disease, and the usual remedies, starting with medications, then moving to devices if needed, and, as a last option, an implanted prosthesis, all of which have had high rates of success.. Erectile dysfunction is the persistent inability to achieve or maintain a penile erection for satisfactory sexual performance, Trussell says, and it\'s an issue for more men as they get older. He describes the types of ED, contributing factors including stress, diabetes and heart disease, and the usual remedies, starting with medications, then moving to devices if needed, and, as a last option, an implanted prosthesis, all of which have had high rates of success.'