Aetna considers topical cream or gel containing vasodilators, such as verapamil cream, experimental and investigational for the treatment of erectile dysfunction because their effectiveness for this indication has not been established.
When possible, “nerve-sparing” methods are used in radical prostatectomy, radical cystectomy, AP resection, or TME. In nerve-sparing surgery, doctors carefully try to avoid these nerves. When the size and location of a tumor allow for nerve-sparing surgery, more men recover erections than with other techniques. But even if the surgeon is able to spare these nerves, they might still be injured during the operation and need time to heal. .
When medications are the culprit, a prescription change may resolve ED. “Occasionally we get referrals and speak to the patient’s psychiatrist, cardiologist, or primary care provider to see if his medication can be changed,” Dr. Baumgarten says. “We often see improvement once the switch is made.”
Men with diabetes, radical prostatectomy, and other complicating factors may still benefit from treatment with a phosphodiesterase type-5 inhibitor such as Viagra. Patients who fail a trial of PDE5 inhibitor should be informed of the benefits and risks of other therapies. This of a different PDE5 inhibitor is unlikely to have a profound effect on sexual function and someone who fails a first drug trial, but should be considered in selected cases. Second-line therapies include intra-urethral suppositories, intra-cavernous drug injection, vacuum-constriction devices, and penile prosthesis. Medicated Urethral System for Erection (MUSE). MUSE is an intra-urethral suppository of alprostadil, of vaso-active drug that relaxes smooth muscle in the penis and induces penile erection. Although not as effective as intra-cavernosal penile injection, MUSE is a less invasive treatment option. An initial trial dose of intra-urethral alprostadil should be administered under healthcare provider supervision due to the risk of fainting. The cost of intra-urethral suppositories is high with respect to the overall success and therefore should be used judiciously.
ED may be a side effect of medication, including certain blood pressure drugs and antidepressants. Talk to your doctor if you think a prescription or over-the-counter drug may be causing erectile problems. But never stop taking any medicine before you discuss it with your doctor.
There is insufficient information on the safety of vardenafil in men with the following health disorders:
The symptoms of Erectile Dysfunction are diagnosed through detailed medical, sexual, and social history. There may be a very low sex drive in men. Some laboratory evaluations are done to screen the unrecognized systemic diseases and test the hormonal causes if any, like change in testosterone and prolactin level. If reports show low testosterone level: The sexologist in Jaipur we check follicle-stimulating hormone and then prescribe
Sildenafil (Viagra) may affect another phosphodiesterase enzyme in the eye causing transient abnormal vision (seeing a bluish hue or brightness).
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Dr. Natalya Lopushnyan treats many patients suffering from erectile dysfunction. Below is an article she wrote describing erectile dysfunction treatment options.
Many people assume that ED is inevitable in older men, but Dr. Baumgarten says this is a misconception. “As men age, they tend to have more medical problems, such as cardiac issues or issues with blood pressure,” he says. “Those medical problems can lead to ED.”
Pills are an easy way to treat ED, but you might get a stronger erection from injecting medication directly into your penis. That’s because these drugs widen your blood vessels so your penis fills with blood. Another option: A medicated pellet you put into the opening at the end of your penis. The pellet can trigger an erection within 10 minutes.
As with most other organ system in the human body, changes and loss of function is normal consequence of the ageing process. This is also true of the endocrine system, specifically the levels of testosterone production from the Leydig cells of the testicle. Accompanying the decrease in testosterone is a decrease in erections which also has a component in decrease in the blood supply to the penis making erection not as frequent and not as rigid compared with a young man’s erectile function. Although these changes are in itself not life threatening, they can impact a man’s relationship with his partner, and also ED may be a harbinger of other undiagnosed conditions such as coronary artery disease (CAD), hypercholesterolaemia or diabetes mellitus.6
Clinicians should be aware of these possible detrimental effects of TRT and the possible contraindications, and to prescribe and monitor in an appropriate manner, which may vary from patient to patient.
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However, his most recent video delves into erectile dysfunction: a sexual disorder which one in every ten men suffer from at some point in their life, but due to the stigma attached to it, remains largely undiscussed in our society. “It’s time we braved into the topic of sexual health” he wrote in his caption, and then went ahead and demonstrated a range of exercises that will boost the flow of blood and bring sexual energy back to the pelvic region.
If your urologist suspects a particular medication to be the root cause of your erectile dysfunction (ED), they may offer an alternative drug. However, do not stop taking medications without their advice.