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Main article: penis pump
Sex therapy is a short-term form of counseling, generally involving 5 to 20 sessions with a sex therapist. A typical session may be one hour every week or every other week.
The safety and efficacy of tadalafil in the treatment of erectile dysfunction was evaluated in 22 clinical trials involving more than 4,000 men. Seven of these trials were randomized, prospective, placebo-controlled studies of 12 weeks' duration. Two of these studies (involving 402 men) were conducted in the Untied States, and the other five studies (involving 1112 men) were conducted outside the Untied states. Two of these trials were conducted in special erectile dysfunction populations; one in men with diabetes mellitus, another in men who developed erectile dysfunction after nerve-sparing prostate cancer surgery.
Patients who are refractory to sildenafil may benefit from vardenafil or tadalafil therapy. If none of these is successful, combine the agent with an injection of prostaglandin E-1. Gutierrez et al demonstrated that this combination was more effective than either one alone. Other successful combinations include using a PDE-5 inhibitor with MUSE.5
Trauma to the pelvic region or spinal cord can damage veins and nerves needed for erection. Surgery of the colon, prostate, bladder, or rectum may damage the nerves and blood vessels involved in erection. Prostate and bladder cancer surgery often require removing tissue and nerves surrounding a tumor, which increases the risk for impotence.
Significant adverse effects (eg, fluid retention, liver damage)
Between 15 and 30 million American men suffer from erectile dysfunction or impotence. Erectile dysfunction refers to an ongoing inability to get or maintain an erection. Impotence includes other sexual health problems such as a lack of sexual desire, or problems with ejaculation.
Restless leg syndrome "afflicts a significant portion of our population and in a minority of cases can cause insomnia and other important consequences," said Dr. Robert Vorona, an associate professor at Eastern Virginia Medical School in Virginia who studies sleep disorders.
Alprostadil is a hormone like substance that is referred to as prostaglandin E1, a known and potent vasodilator (improver of blood flow). Alprostadil has the power to directly effect the tissue that it comes into contact with. (3) An erection essentially occurs when the blood vessels widen in the genital region and allow the corpus caverosum to fill with blood, and hence the penis becomes erect and stiff. So, it is easy to see the direct role that alprostadil plays in the creation of an erection.
Who should not use vardenafil (Levitra)?
Safety concerns and adverse effects have been studied carefully. The most common adverse effects are headaches and upper GI distress. These are not usually severe and are self-limited when the drug is stopped. Sildenafil is a mild inhibitor of phosphodiesterase type 6, which is found in the retina. This inhibition is manifested by a blue haze at the periphery of the field of vision but is not dangerous. Very few patients have stopped taking sildenafil because of this effect.
Men taking another protease inhibitor ritonavir (Norvir) should not take more than 2.5 mg of vardenafil every 72 hours.
"The appearance of racialized drugs on pharmacist's shelves only increases the need to attend to the myriad social sources of disparities in morbidity and mortality," Duster wrote. "Although to turn a profit from fighting racial discrimination is difficult, effective medical care requires continued awareness of the complex social dimensions of diseases, such as hypertension and cancer."
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