Concierge 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.
Why patients choose us
- 01
A subspecialty consultant
A UK andrology or sexual medicine consultant matched to your case, not a generalist on a list.
- 02
Booked in days, not weeks
Weekday, evening and weekend slots across London and the major UK cities.
- 03
Independent, and free
We take no fee from clinics, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private ED care costs in London.
Indicative ranges across our partner units. Send the details and we quote firm figures across two or three options, with cover checked.
In short
Consultation from £150, PDE5 from £15/month, implant surgery from £16,000.
| Service | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Initial consultation | £150–£350 | 30–45 min | Same visit |
| Full workup (bloods, exam, Doppler) | £250–£450 | 60–90 min | 48–72 hours |
| PDE5 inhibitor prescription | £15–£45 per month | Ongoing | Same day |
| Low-intensity shockwave course (Li-ESWT) | £1,500–£3,500 | 6–12 sessions | 6–12 weeks |
| TriMix / Invicorp injection training | £250–£450 | 45 min | Same visit |
| Inflatable penile prosthesis | £16,000–£28,000 | Day case, 60–90 min | 6–8 weeks recovery |
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.
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NHS waits are long
Andrology and sexual medicine waits vary by region. Private care shortens the timeline and lets you choose the consultant.
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The right consultant matters
Outcomes in prosthesis, shockwave and injection therapy track with volume and subspecialisation, not hospital brand.
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Insurer processes are opaque
We handle preauth, coding and any second-opinion requirements on your behalf.
The journey
From enquiry to follow-up - what happens, in order.
One team from first message through workup, treatment and titration.
- 01
Before
Send us your history
Onset, situational or global, meds, prior investigations. A short message is enough.
- 02
Before
Match to a consultant
A London andrologist or sexual medicine consultant matched to your case.
- 03
Before
Preparation instructions
Fasting for bloods, medication and consent guidance ahead of the visit.
- 04
On the day
Workup and assessment
History, examination, bloods and, where indicated, penile Doppler in a CQC-registered unit.
- 05
On the day
Tailored treatment plan
Options walked through with you, from PDE5 to shockwave, injections or implant referral.
- 06
After
Report and results
Consultant report the same week, sent to you and, with consent, your GP.
- 07
After
Follow-up and titration
Dose or device titration, escalation between lines of therapy and psychological input where useful.
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.
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Focused history
Onset, nocturnal erections, situational vs global, meds, psychological factors, partner relationship.
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Examination
Genital exam, secondary sexual characteristics, femoral pulses and, where indicated, digital rectal exam.
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Bloods
Morning total testosterone, SHBG, LH, FSH, prolactin, HbA1c, fasting lipids, U&E and PSA where indicated.
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Penile Doppler ultrasound
Arterial inflow and venous leak assessment after intracavernosal test dose. Reserved for vascular workup.
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Nocturnal penile tumescence
Rarely used now. Reserved for medico-legal cases or when organic vs psychogenic remains unclear.
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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.
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Vascular disease
The commonest organic cause. ED is often the first sign of coronary or peripheral arterial disease.
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Type 2 diabetes
Neurovascular damage. Screen with HbA1c in every workup.
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Testosterone deficiency
Confirmed on two morning samples with LH, FSH, SHBG and prolactin per BSSM UK guidance.
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Medication side effect
Antihypertensives, SSRIs, opioids, finasteride and antipsychotics are common culprits.
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Psychogenic
Situational ED, performance anxiety, relationship strain, depression. Preserved nocturnal erections are a clue.
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Neurological
Spinal cord injury, multiple sclerosis, post-prostatectomy nerve damage, autonomic neuropathy.
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Penile disease
Peyronie's disease with plaque and curvature can produce mechanical ED and pain.
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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.
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Sildenafil (Viagra)
PRN, 30–60 min before sex. 50–100 mg. First-line for most men.
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Tadalafil (Cialis)
PRN 10–20 mg or daily 2.5–5 mg for a spontaneous window across 24–36 hours.
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Vardenafil (Levitra)
Similar profile to sildenafil. Useful when sildenafil fails or is not tolerated.
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Avanafil (Spedra)
Faster onset, cleaner side-effect profile in many men.
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Lifestyle change
Weight loss, aerobic exercise, smoking cessation, alcohol reduction and sleep improvement.
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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.
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Vacuum erection device
Non-invasive, works for most men, useful after prostatectomy for penile rehabilitation.
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Intracavernosal injections
Caverject (alprostadil), Invicorp or compounded TriMix. Highly effective when PDE5 fails.
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MUSE urethral pellet
Alprostadil pellet inserted into the urethra. Needle-free alternative for selected patients.
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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.
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Inflatable penile prosthesis
Coloplast Titan or AMS 700. Day-case surgery with reported satisfaction close to 100 per cent.
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Semi-rigid rod prosthesis
Simpler device for men with limited dexterity or after complex reconstruction.
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Revision surgery
For device failure, infection or erosion. Volume matters, so consultant choice matters.
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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. COSRT and BABCP accredited therapists in our network.
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CBT for performance anxiety
Structured, short-course therapy with a BABCP-accredited therapist. Often combined with a PDE5 to break the cycle.
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Couples and sex therapy
COSRT-accredited psychosexual therapists for relationship-driven ED and communication work.
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Mindfulness and sensate focus
Evidence-based programmes to reduce anticipatory anxiety and restore intimacy.
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Depression and trauma
Onward referral where mood, trauma or medication side effect is the primary driver.
Where it happens in London
A small panel of London andrology units, we picked them.
Introductions are made privately, once we understand your case. Everyone on the panel is CQC-registered and consultant-led.
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The London Andrology Centre - subspecialty andrology and prosthesis surgery
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Cromwell Bupa Men's Health Clinic - workup and medical therapy
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HCA The Wellington - urology and andrology consultant network
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University College London Hospital Andrology Private - complex and post-prostatectomy cases
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Male Sexual Health Centre - shockwave, injection therapy and psychosexual support
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CQC-registered day units with insurer preauth handled directly
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.
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Cardiovascular check
BP, lipids and 10-year risk before starting therapy. ED is often the first sign of coronary disease.
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Nitrate contraindication
PDE5 inhibitors cannot be used with nitrates or nicorandil. Full drug review at consultation.
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Injection side effects
Bruising, priapism risk and fibrosis. Training and titration reduce risk.
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Shockwave limitations
Evidence is best for mild-to-moderate vasculogenic ED. Not a cure and not for severe disease.
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Prosthesis risks
Infection under 2 per cent in high-volume hands. Mechanical failure at 10–15 years.
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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.
- 01 Header
History and consent
Onset, situational features, meds, prior therapy and what was consented at the visit.
- 02 Findings
Examination and results
Genital exam, bloods, hormone profile, Doppler measurements where done.
- 03 Assessment
Consultant interpretation
Vascular, hormonal, neurogenic, psychogenic or mixed and what that means for you.
- 04 Impression
Plan and next step
Read this first. First-line therapy, review timing and escalation plan if needed.
Recognised by major UK insurers
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.
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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.
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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.
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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.
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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. Shockwave and prosthesis are variable and we check cover before quoting.
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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.
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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.
Related
Looking for something else?
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Testosterone replacement therapy
Confirmed hypogonadism, consultant-led.
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Premature ejaculation treatment
Behavioural and medical options.
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Frenuloplasty
Day-case correction of a tight frenulum.
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Type 2 diabetes
A common driver of ED.
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Hypertension
Medication side effects and vascular ED.
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Conditions library
Guides for common conditions.
Learn more
Speak to us
A discreet consultation, a clear plan, and the right consultant.
Send a short message with the history and any prior investigations. We reply within one working day with two or three London options, with cover checked.