Implants and Revascularization Treatments of Erectile Dysfunction Third line therapies, which are a more serious treatment approach, include penile implants, and in rare cases, revascularization. Implants are a permanent solution to ED, and are excellent permanent choices for men whose underlying cause cannot be treated, or are unresponsive to other treatments. There are generally two different kinds: bendable or semi-rigid rods, and multi-piece inflatable implants. Both of these are implanted into the penile tissue itself. The bendable rods, also known as a malleable device, create erections when the patient straightens their penis by hand into an erect position. Inflatable implants are significantly more natural looking, and tend to be concealed better than malleable implants. They consist of two inflatable cylinders, a pump, and a reservoir that holds fluid. Insertion of penile implants generally requires local, spinal, or general anesthesia, and the patient may need to stay overnight. The patient can resume sexual activity approximately one month after the surgery, depending on the healing process. The procedure is relatively simple, and is not particularly invasive, but because it is permanent, it should be considered as a last resort for treating ED.
Revascularization is performed on patients with considerable damage to the primary artery in the penis that leaves the patient with an inability to obtain erections. It is rarely used as a treatment option for ED, but rather for patients with serious injuries to the penile artery.
Monday, 28 October 2013
Erectile Dysfunction Treatment Self injection Therapy
Erectile Dysfunction Treatment Self injection Therapy
Self injection therapy offers the patient quick results, and a high success rate (80%) with minimal side effects. The injected solution is a prescription medication (often Caverject Impulse or Edex) or a mixture combined by a physician or pharmacy often contains, papaverine, phentolamine and/or alprostadil. Unwanted results such as priapism can be a result of an overdose. Rare side effects such as bruising, bleeding, or a build up of scar tissue (fibrosis) may also occur in some patients. Transurethral therapy involves a medicated urethral system (MUSE) to deposit medication in to the urethra in order to obtain erections. The patient will place the suppository inside the urethra with a specially designed applicator. MUSE is quite safe, but some patients do find side effects such as burning, bleeding, pain, or low blood pressure.
Self injection therapy offers the patient quick results, and a high success rate (80%) with minimal side effects. The injected solution is a prescription medication (often Caverject Impulse or Edex) or a mixture combined by a physician or pharmacy often contains, papaverine, phentolamine and/or alprostadil. Unwanted results such as priapism can be a result of an overdose. Rare side effects such as bruising, bleeding, or a build up of scar tissue (fibrosis) may also occur in some patients. Transurethral therapy involves a medicated urethral system (MUSE) to deposit medication in to the urethra in order to obtain erections. The patient will place the suppository inside the urethra with a specially designed applicator. MUSE is quite safe, but some patients do find side effects such as burning, bleeding, pain, or low blood pressure.
Vacuum Therapy for Erectile Dysfunction
Sometimes oral medications for ED are not effective for a patient, or
may be incompatible with their medical history. Second-line therapy
includes vacuum constriction devices, penile self-injection, and
transurethral therapy. Vacuum constriction devices (VCDs) have actually
been around for quite some time, and the ErecAid is the most popular
option. A cylinder is placed over the penis, and then a pumping action
pulls blood into the penis, causing an erection. The man may then slide a
band or ring on to the base of their penis in order to retain the
erection, and the ring may be left in place for up to 30 minutes. Vacuum
therapy is generally safe, but can be associated with bruising, pain,
and a decrease in the force of ejaculation. The vacuum does not
interfere with medication, and can be combined with other therapies.
"Our data support the potential benefits of a combination therapy with one of the oral medications such as Viagra, Levitra or Cialis plus testosterone for men with erectile dysfunction and low testosterone who find the oral medications by themselves ineffective," said Dr. Shabsigh. "When assessing erectile dysfunction, doctors and patients should consider using a simple blood test to determine if low testosterone is a contributing factor.
"Our data support the potential benefits of a combination therapy with one of the oral medications such as Viagra, Levitra or Cialis plus testosterone for men with erectile dysfunction and low testosterone who find the oral medications by themselves ineffective," said Dr. Shabsigh. "When assessing erectile dysfunction, doctors and patients should consider using a simple blood test to determine if low testosterone is a contributing factor.
Erectile Dysfunction Drug Treatments
Erectile Dysfunction Drug Treatments
Another first-line treatment for ED is PDE-5 inhibitors. This family of drugs includes Sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). They typically begin working within 20 to 30 minutes. The effects of Viagra and Levitra generally last for about 6 to 8 hours, and the effects of Cialis last for up to 36 hours. The choice of medication depends on the patient history, as well as the desired effect. Cialis is more flexible in terms of timing for sexual activity. These drugs have minor side effects such as headache, facial flushing, upset stomach, nasal congestion, and back pain. This type of medications is contraindicated in men taking nitrates medications and may not be generally used in men for whom sexual activity is inadvisable due to their underlying cardiovascular statu
Another first-line treatment for ED is PDE-5 inhibitors. This family of drugs includes Sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). They typically begin working within 20 to 30 minutes. The effects of Viagra and Levitra generally last for about 6 to 8 hours, and the effects of Cialis last for up to 36 hours. The choice of medication depends on the patient history, as well as the desired effect. Cialis is more flexible in terms of timing for sexual activity. These drugs have minor side effects such as headache, facial flushing, upset stomach, nasal congestion, and back pain. This type of medications is contraindicated in men taking nitrates medications and may not be generally used in men for whom sexual activity is inadvisable due to their underlying cardiovascular statu
Medical Treatments of Erectile Dysfunction
Medical Treatments of Erectile Dysfunction
In addition lifestyle or psychosocial changes, the doctor may discuss medical treatment options. A blood test may discover a testosterone deficiency, and therefore testosterone replacement therapy may be a good choice. Testosterone deficiency is infrequently the only cause of ED, but it may contribute to ED in as many as 34% of affected individuals. If the doctor finds low testosterone along with other factors such as low sexual desire, erectile dysfunction, ejaculatory dysfunction, fatigue, muscle weakness, obesity, or an unstable mood, the doctor may prescribe testosterone replacement therapy. Testosterone therapy is not recommended for men with female partners trying to conceive, as sperm counts may be affected.
In addition lifestyle or psychosocial changes, the doctor may discuss medical treatment options. A blood test may discover a testosterone deficiency, and therefore testosterone replacement therapy may be a good choice. Testosterone deficiency is infrequently the only cause of ED, but it may contribute to ED in as many as 34% of affected individuals. If the doctor finds low testosterone along with other factors such as low sexual desire, erectile dysfunction, ejaculatory dysfunction, fatigue, muscle weakness, obesity, or an unstable mood, the doctor may prescribe testosterone replacement therapy. Testosterone therapy is not recommended for men with female partners trying to conceive, as sperm counts may be affected.
Erectile Dysfunction Affects Quality of Life
Erectile Dysfunction Affects Quality of Life
If a serious medical condition (such as depression, diabetes, high blood pressure, obesity, or a metabolic disorder) is affecting sexual function, it may be affecting other areas of life as well, reducing the quality of life, and consequently should be treated. There are treatments that can be performed at home and during the day that will allow a surprising amount of control over erectile dysfunction. Many natural substances are reported to provide benefits in this area as well. These include Korean gingseng, L-arginine, vitamin E, Chinese herbal remedies, and ginko biloba.
Some of these have been tested by clinical studies, however it’s important to remember that many over-the-counter medications are not regulated. These medications could be dangerous, or cause harmful interactions with other medications. It’s a good idea to consult the National Institute of Health’s (NIH) online database ( www.pubmed.gov ) to research possible supplements. Also, be sure to tell the doctor about any drug or supplement that is being taken.
When lifestyle approaches or disease management fails to address a patient’s sexual dysfunction, Dr. Shabsigh discusses a broad range of medical and surgical options with men and couples. During this process, he considers patient preferences related to invasiveness, convenience, effectiveness, possible side effects, partner satisfaction, and cost. Once the doctor and patient agree on an approach, treatment is administered.
If a serious medical condition (such as depression, diabetes, high blood pressure, obesity, or a metabolic disorder) is affecting sexual function, it may be affecting other areas of life as well, reducing the quality of life, and consequently should be treated. There are treatments that can be performed at home and during the day that will allow a surprising amount of control over erectile dysfunction. Many natural substances are reported to provide benefits in this area as well. These include Korean gingseng, L-arginine, vitamin E, Chinese herbal remedies, and ginko biloba.
Some of these have been tested by clinical studies, however it’s important to remember that many over-the-counter medications are not regulated. These medications could be dangerous, or cause harmful interactions with other medications. It’s a good idea to consult the National Institute of Health’s (NIH) online database ( www.pubmed.gov ) to research possible supplements. Also, be sure to tell the doctor about any drug or supplement that is being taken.
When lifestyle approaches or disease management fails to address a patient’s sexual dysfunction, Dr. Shabsigh discusses a broad range of medical and surgical options with men and couples. During this process, he considers patient preferences related to invasiveness, convenience, effectiveness, possible side effects, partner satisfaction, and cost. Once the doctor and patient agree on an approach, treatment is administered.
Premature Ejaculation
What is Premature Ejaculation ?
Premature ejaculation is the inability to control ejaculation shortly after or upon vaginal penetration causing personal distress and/or relationship problem. Premature ejaculation is the most common male sexual dysfunction. It affects over 30% of men during their lifetimes (more than twice the amount affected by ED). While some men may assume that age is a culprit, it is not always the contributing factor. Premature ejaculation can cause strong psychological problems, resulting in depression, frequent arguments with sexual partners, feelings of isolation, and ultimately can lead to marital problems such as divorce.
Premature Ejaculation Risk Factors
Risk factors for premature ejaculation vary greatly from individual to individual. The National Health and Social Life Survey lists risk factors such as poor to fair health, high stress levels, and emotional problems such as depression. Many men with premature ejaculation may become frustrated with their sex lives and consequently their relationship, and therefore may not have enjoyable sex. They may feel they have disappointed their sexual partner and consequently experience a severe drop in self esteem. Even though it’s the most common sexual dysfunction, patients still feel uncomfortable discussing it with their sexual partner and especially their physician. An estimated 4 out of 5 men who suffer from PE will not discuss it with their physician. Additionally, over two thirds of men who suffer from ED think that it is “not serious” or will “go away with time,” and try to rationalize the problem instead of treating it.
Prevention and Treatment of Premature Ejaculation
A healthy lifestyle is the foundation of Dr. Shabsigh’s program for sensational sex. He stresses that the decisions you make about your habits, nutrition, care and stresses along with your principal relationship can all affect sexual function. Making better decisions in all areas of life leads to better sex. If a physician diagnoses premature ejaculation, treatment options may include behavioral therapy (sex therapy) and lifestyle modifications. Physicians may also prescribe creams or medications. It’s important to review treatment with a physician to identify what will work best.
Premature ejaculation is the inability to control ejaculation shortly after or upon vaginal penetration causing personal distress and/or relationship problem. Premature ejaculation is the most common male sexual dysfunction. It affects over 30% of men during their lifetimes (more than twice the amount affected by ED). While some men may assume that age is a culprit, it is not always the contributing factor. Premature ejaculation can cause strong psychological problems, resulting in depression, frequent arguments with sexual partners, feelings of isolation, and ultimately can lead to marital problems such as divorce.
Premature Ejaculation Risk Factors
Risk factors for premature ejaculation vary greatly from individual to individual. The National Health and Social Life Survey lists risk factors such as poor to fair health, high stress levels, and emotional problems such as depression. Many men with premature ejaculation may become frustrated with their sex lives and consequently their relationship, and therefore may not have enjoyable sex. They may feel they have disappointed their sexual partner and consequently experience a severe drop in self esteem. Even though it’s the most common sexual dysfunction, patients still feel uncomfortable discussing it with their sexual partner and especially their physician. An estimated 4 out of 5 men who suffer from PE will not discuss it with their physician. Additionally, over two thirds of men who suffer from ED think that it is “not serious” or will “go away with time,” and try to rationalize the problem instead of treating it.
Prevention and Treatment of Premature Ejaculation
A healthy lifestyle is the foundation of Dr. Shabsigh’s program for sensational sex. He stresses that the decisions you make about your habits, nutrition, care and stresses along with your principal relationship can all affect sexual function. Making better decisions in all areas of life leads to better sex. If a physician diagnoses premature ejaculation, treatment options may include behavioral therapy (sex therapy) and lifestyle modifications. Physicians may also prescribe creams or medications. It’s important to review treatment with a physician to identify what will work best.
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