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That is, initial treatment is based on lifestyle modification followed by first line therapies using PDE5 inhibitors and vacuum erection devices. Injection therapy is very successful in those men who do not respond to tablets. Here s where to find out more about the pros and cons of services like these. More blood flows in and less flows out of the penis, hardening the tissue in the corpus cavernosum. Teen guys should have testicular exams every year at their regular checkup.