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Andrology · London

Erectile dysfunction clinic - private in London.

A discreet, consultant-led workup for erectile dysfunction with a tailored plan. From PDE5 inhibitors and lifestyle change through shockwave, vacuum devices and injections, up to penile implant when needed. Every plan starts by identifying the underlying cause.

A stethoscope on a clinical desk

Indicative pricing

What private ED care costs in London.

Indicative ranges across UK units.

In short

Consultation from £150, PDE5 from £15/month, implant surgery from £16,000.

Service Indicative range
Initial consultation £150–£350
Full workup (bloods, exam, Doppler) £250–£450
PDE5 inhibitor prescription £15–£45 per month
Low-intensity shockwave course (Li-ESWT) £1,500–£3,500
TriMix / Invicorp injection training £250–£450
Inflatable penile prosthesis £16,000–£28,000

Prices vary by hospital, by consultant and by the complexity of your case. Shockwave and prosthesis are not always covered by insurance and cover is checked before quoting.

The problem

The right therapy, at the right time, with the right consultant.

NHS andrology is excellent but capacity is stretched. Private care shortens the timeline and lets you choose the consultant.

  • NHS waits are long

    Andrology and sexual medicine waits vary by region. Private care shortens the timeline and lets you choose the consultant.

  • The right consultant matters

    Outcomes in prosthesis, shockwave and injection therapy track with volume and subspecialisation, not hospital brand.

Clinical workup

What a proper ED workup includes.

Every plan starts with a clear diagnosis. The workup is thorough but proportionate and everything is explained.

  • Focused history

    Onset, nocturnal erections, situational vs global, meds, psychological factors, partner relationship.

  • Examination

    Genital exam, secondary sexual characteristics, femoral pulses and, where indicated, digital rectal exam.

  • Bloods

    Morning total testosterone, SHBG, LH, FSH, prolactin, HbA1c, fasting lipids, U&E and PSA where indicated.

  • Penile Doppler ultrasound

    Arterial inflow and venous leak assessment after intracavernosal test dose. Reserved for vascular workup.

  • Nocturnal penile tumescence

    Rarely used now. Reserved for medico-legal cases or when organic vs psychogenic remains unclear.

  • Cardiovascular risk review

    ED can be an early sign of coronary disease. BP, lipids and 10-year CV risk are standard.

Underlying causes

What we look for.

ED usually has more than one driver. Identifying each one shapes the treatment plan.

  • Vascular disease

    The commonest organic cause. ED is often the first sign of coronary or peripheral arterial disease.

  • Type 2 diabetes

    Neurovascular damage. Screen with HbA1c in every workup.

  • Testosterone deficiency

    Confirmed on two morning samples with LH, FSH, SHBG and prolactin per BSSM UK guidance.

  • Medication side effect

    Antihypertensives, SSRIs, opioids, finasteride and antipsychotics are common culprits.

  • Psychogenic

    Situational ED, performance anxiety, relationship strain, depression. Preserved nocturnal erections are a clue.

  • Neurological

    Spinal cord injury, multiple sclerosis, post-prostatectomy nerve damage, autonomic neuropathy.

  • Penile disease

    Peyronie's disease with plaque and curvature can produce mechanical ED and pain.

  • Lifestyle

    Smoking, heavy alcohol, obesity, poor sleep, sedentary lifestyle all contribute.

First-line treatment

PDE5 inhibitors and lifestyle change.

Effective for most men. Choice of PDE5 depends on onset, duration and other medications.

  • Sildenafil (Viagra)

    PRN, 30–60 min before sex. 50–100 mg. First-line for most men.

  • Tadalafil (Cialis)

    PRN 10–20 mg or daily 2.5–5 mg for a spontaneous window across 24–36 hours.

  • Vardenafil (Levitra)

    Similar profile to sildenafil. Useful when sildenafil fails or is not tolerated.

  • Avanafil (Spedra)

    Faster onset, cleaner side-effect profile in many men.

  • Lifestyle change

    Weight loss, aerobic exercise, smoking cessation, alcohol reduction and sleep improvement.

  • Cardiovascular risk factors

    BP, lipids, glucose and, where relevant, statin therapy addressed as part of the plan.

Second-line treatment

When PDE5 fails or is contraindicated.

Physical devices, intracavernosal or urethral therapy and, in selected men, low-intensity shockwave.

  • Vacuum erection device

    Non-invasive, works for most men, useful after prostatectomy for penile rehabilitation.

  • Intracavernosal injections

    Caverject (alprostadil), Invicorp or compounded TriMix. Highly effective when PDE5 fails.

  • MUSE urethral pellet

    Alprostadil pellet inserted into the urethra. Needle-free alternative for selected patients.

  • Low-intensity shockwave (Li-ESWT)

    6–12 sessions, evidence best for mild-to-moderate vasculogenic ED, not for severe cases.

Third-line treatment

Penile prosthesis surgery.

A considered, definitive option when other lines have not worked. Reported satisfaction is close to 100 per cent in the right hands.

  • Inflatable penile prosthesis

    Coloplast Titan or AMS 700. Day-case surgery with reported satisfaction close to 100 per cent.

  • Semi-rigid rod prosthesis

    Simpler device for men with limited dexterity or after complex reconstruction.

  • Revision surgery

    For device failure, infection or erosion. Volume matters, so consultant choice matters.

  • Consent and recovery

    Overnight stay is common. Device activation at 4–6 weeks with a specialist nurse.

Psychological support

Talking therapy, when it belongs in the plan.

Performance anxiety and relationship strain often coexist with organic ED.

  • CBT for performance anxiety

    Structured, short-course therapy with a BABCP-accredited therapist. Often combined with a PDE5 to break the cycle.

  • Couples and sex therapy

    COSRT-accredited psychosexual therapists for relationship-driven ED and communication work.

  • Mindfulness and sensate focus

    Evidence-based programmes to reduce anticipatory anxiety and restore intimacy.

  • Depression and trauma

    Onward referral where mood, trauma or medication side effect is the primary driver.

Important safety notes

ED can be the first symptom of coronary disease.

A cardiovascular workup is a routine part of assessment. The safety profile of each treatment is well understood and the honest bits are here.

  • Cardiovascular check

    BP, lipids and 10-year risk before starting therapy. ED is often the first sign of coronary disease.

  • Nitrate contraindication

    PDE5 inhibitors cannot be used with nitrates or nicorandil. Full drug review at consultation.

  • Injection side effects

    Bruising, priapism risk and fibrosis. Training and titration reduce risk.

  • Shockwave limitations

    Evidence is best for mild-to-moderate vasculogenic ED. Not a cure and not for severe disease.

  • Prosthesis risks

    Infection under 2 per cent in high-volume hands. Mechanical failure at 10–15 years.

  • Psychological safety

    Screening for depression, anxiety and relationship distress is part of every workup.

Reading your notes

Your report in four parts. Read the last one first.

Whichever centre you attend, the report keeps to the same shape.

  1. 01 Header

    History and consent

    Onset, situational features, meds, prior therapy and what was consented at the visit.

  2. 02 Findings

    Examination and results

    Genital exam, bloods, hormone profile, Doppler measurements where done.

  3. 03 Assessment

    Consultant interpretation

    Vascular, hormonal, neurogenic, psychogenic or mixed and what that means for you.

  4. 04 Impression

    Plan and next step

    Read this first. First-line therapy, review timing and escalation plan if needed.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Consultation and workup are usually covered by UK private medical insurance. Shockwave and prosthesis vary and cover is checked before quoting.

Frequently asked

Everything we get asked about ED.

  • Do I really need a cardiovascular check?

    In most cases, yes. Erectile dysfunction can be the first sign of coronary artery disease and can precede a cardiac event by three to five years. BP, lipids, glucose and cardiovascular risk assessment are part of any thorough workup.

  • Can pornography use cause erectile dysfunction?

    The evidence is mixed. Some men report improvement after reducing use, and behavioural change can be part of the plan, but for most men presenting to clinic the primary drivers are vascular, hormonal, medication-related or psychological. A proper workup rules those in or out first.

  • Can psychological ED be cured?

    Often, yes. Situational and performance-anxiety ED responds well to CBT with a BABCP-accredited therapist and, where relevant, short-term PDE5 support to break the cycle. Couples work through a COSRT-accredited therapist helps when the relationship is a factor.

  • Is erectile dysfunction treatment covered by UK private medical insurance?

    Consultation, workup and many treatments are usually covered by Bupa, AXA, Vitality, Aviva, WPA and Cigna with a specialist referral and a clear clinical indication.

  • Does low-intensity shockwave therapy actually work?

    Evidence supports Li-ESWT for mild-to-moderate vasculogenic ED, with meaningful benefit in around 60 per cent of well-selected patients. It is not a cure, does not help severe disease and is not a substitute for cardiovascular risk management.

  • Is a penile implant reversible?

    The device can be removed, but implant surgery destroys the erectile tissue as it is placed. After removal, natural or medically induced erections are no longer possible. This is why implant is a third-line, considered decision after PDE5, injections and vacuum devices have been tried.

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