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If the medicines aren't right for you, you could also try using a penile implant, vacuum pump devices, or you could have surgery. Your doctor may send you to an urologist to talk about these options.
Some health professionals, including doctors and mental health professionals, may not feel comfortable discussing sexuality and erection problems. Ask your health professional if he or she feels comfortable with and has experience in working with men who have erection problems.
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The most important component of diagnosing erectile dysfunction is obtaining a complete medical and sexual history. It is important to distinguish the condition from other sexual dysfunctions, such as premature ejaculation and loss of libido. Several formalized sexual questionnaires, such as the IIEF (Internation Index of Erectile Function) and EDITS (Erectile Dysfunction Inventory of Treatment Satisfaction), allow one to detect the presence and grade the severity of erectile dysfunction. The complete IIEF is composed of 15 questions; an abridged 5-item version, called the sexual health inventory for men (SHIM), has been developed and validated.29 Allowing a patient to complete such a questionnaire before his first clinical encounter may produce a more comfortable clinical environment.30 The duration of the problem, time of onset and degree of patient and partner concern should also be elucidated. The circumstances surrounding erectile dysfunction may be helpful in determining whether a situational or nonorganic factor is involved. Sudden onset, maintenance of nocturnal erections, presence of psychological problems and concurrent major life events or relationship issues may be associated with nonorganic erectile dysfunction.31 Concurrent medical illnesses and any medications the patient may be taking should be reviewed. Erectile dysfunction is often a component of generalized medical illness and may represent the initial presentation of cardiovascular disease or diabetes. The history may also reveal certain reversible or modifiable risk factors, such as tobacco use or inadequate diabetes control.
Men with moderately severe liver disease also should not take more than a 5 mg dose of vardenafil in a 24-hour period.
The long-term efficacy of sildenafil has been shown in a 48-month, open-label, noncontrolled, flexible-dose study. One year following the initiation of therapy, efficacy and satisfaction continued to be significantly improved.
Invasive test - allows visualization of the circulation in the penis and is used during the repair of a priapism.
More drastically, inflatable or rigid penile implants may be fitted surgically. Implants are irreversible and costly.
Willingness-to-pay is a tool used to assess health benefits perceived to be due to a health measure  – . In this study, there were no significant changes in the WTP within or between the 3 WTP groups, in those who succeeded with sildenafil therapy. This lack of change / trend in the WTP seems more to reflect the perception of healthcare delivery by the NHS, in that, in spite of successful treatment of their ED, the patients were unwilling to change their WTP category. The other possibility is that the gradations or categories in WTP in this study were probably not sufficiently wide to detect the changes. This study is based in the real world and hence could not include further gradations. It is also likely that if the condition were something more serious, for example, cancer, then the treatment measure and its success may have impacted differently on the perception.
All the patients then completed questionnaires regarding treatment side effects six months, 12 months, and 24 months following radiation.
In fact, many medications have ED as a side effect, but “hypertensive drugs are classically the worst,” says Nehra. However, he emphasizes, you don’t have to endure this side effect. Talk to your urologist about medications that will counter ED without affecting your blood pressure meds.
To understand the link between alcohol and erectile dysfunction, the process of achieving an erection needs to be understood.
Media file 3: Erectile dysfunction. A number of devices have been developed to ascertain the occurrence of an erection during sleep. This snap gauge is fastened around the penis but opens when an erection occurs.
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Table 4. Patient demographics. Ranges and percentages are provided in parentheses.
This oral agent has been available for many years. It has both a central and a peripheral effect. Its efficacy has been questioned because even in properly conducted, well-controlled studies, yohimbine is only slightly better than placebo. A renewed interest in this agent has occurred, particularly when combined with sildenafil or some of the other oral agents.
Birth control pills work mostly by preventing ovulation (the release of an egg by the ovaries). Most pills are made of two hormones called estrogen and progestin. For the pill to work, you have to take it every day.
Exercise regularly. Your body can fight stress better when it is fit.
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