Mr. Bond's New and Improved Gadget
The urologist "Dr. U" then performs a thorough physical examination of the penis, looking specifically for deformities or fibrosis in the corpora. No abnormalities were noted. "U" then injects Mr. Bond's penis with prostaglandin E1, and no erection was achieved. This injection directly relaxes the penile arterioles, and therefore, no neural input is needed to obtain an erection. Since Mr. Bond did not achieve an erection upon injection, he either suffers from an inflow problem (severe peripheral vascular disease) or an outflow problem (a leak in the veno-occlusive mechanism of the penis). Given his history of vascular disease, Mr. Bond most likely suffers from the former.
"U" then discusses with Mr. Bond that he would be a good candidate for surgical placement of a penile prosthesis. "U" shows him various models, and Mr. Bond eagerly decides to have surgery with the high-tech, top-of-the-line inflatable model. A small pump will be placed in his scrotum so that he can pump fluid into the inflatable tubes located in his corpora and speedily obtain a serviceable erection.
Two weeks later, the surgery is performed with no difficulties. Six weeks post-op, "U" instructs Mr. Bond how to "fire this thing up." The resulting erection meets the demanding standards to which Mr. Bond is accustomed.