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Vasoactive drugs may also be injected intracavernosally. Such therapy represents an important second-line therapy for erectile dysfunction. It is the most effective pharmacologic treatment but has a high dropout rate because of the associated pain and apprehension involved. Phentolamine is an -blocker that was used in initial studies; its efficacy is poor, but it may be used in combination with other agents. Papaverine is a nonspecific PDE inhibitor and was the first effective intracavernosal therapy for erectile dysfunction. Currently, intracavernosal alprostadil therapy is preferred; it is more effective than other agents and produces fewer side effects. In a comparison study comparing alprostadil, a papaverine–phentolamine combination and papaverine alone, rates of success (ability to achieve and maintain an erection) of 72%, 61% and 31% were reported respectively.54 No patients in the alprostadil group experienced priapism, as compared with 2% and 4% of patients in the combination therapy and papaverine-only groups respectively. On the other hand, patients who used alprostadil were the only ones to report penile pain. For patients who do not respond to or do not tolerate alprostadil monotherapy, a triple mixture of papaverine, phentolamine and alprostadil may be prescribed. Such combination therapy has been shown to be more effective and, because of a lower dose of alprostadil, results in less pain.62 Complications of intracavernosal injections include pain, priapism and fibrotic changes at injection sites.
The power to prop up the erection depends on the capability of the penile muscle to carry the blood for a certain period.
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Doctors at the Rambam Medical Centre in Haifa, Israel, recruited 20 men with an average age of 56 to take part in the trial.
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Might other non-surgical treatments, such as self-injections, urethral suppositories, or vacuum devices, be helpful? Why or why not?
If this impotence treatment is not successful, what other options might you recommend?
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A new study sheds additional light on how erectile dysfunction (ED) interacts with diabetes. The study is another step in uncovering the link between the two disorders, and may lead to improved efficacy in treatments.
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To report on the attitudes of men, with and without self-reported erectile dysfunction, concerning masculine identity and quality of life. Methods.?
JAMA 1993, 270:83-90. PubMed Abstract
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The urethra, the channel in which urine and sperm flow, which runs along the underside of the corpora cavernosa.
Some evidence suggests that smaller penis size is associated with erectile dysfunction.
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Nutritional Supplements: nutritional supplements including the amino acid arginine, bioflavonoids, zinc, Vitamin C, Vitamin E, and flaxseed meal have been used to improve erectile function. In addition, certain ED patients with low levels of the hormone dehydroepiandrosterone (DHEA) showed improvement in erectile function after receiving supplemental doses of DHEA. However, because the long-term safety of DHEA is not known, most experts do not recommend its use.
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As a partner of a man with ED, you are also affected. Here are some tips to help you better deal with the situation.
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