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The needle used is very fine, so pain from the injection site is usually minimal. It is very important that you receive these injections by a trained urologist. Penile injections not administered under the supervision of a urologist or other trained medical professional can result in serious side effects in some men. Most insurance plans will cover the cost of these injections when you are under the care of a urologist. Erection occurs in five to 20 minutes following injection and lasts up to one hour Can be used anytime Erection feels natural No surgery necessary Can be costly if not covered by insurance May cause bleeding and scarring at the injection site Can cause painful erections that last longer than two hours Lack of spontaneity May require surgery if erection is prolonged 75 percent of men stop using injections after one year Urethral Suppositories

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If your doctor rules out other causes, he or she may prescribe Sildenafil (brand name: Viagra), tadalfil (brand name Cialis), and vardenafil (brand name Levitra). These medicines are taken by mouth to help you maintain an erection.
An injection test is also called an intracavernosal test. Your doctor injects a medicine into the base of your penis that should give you an erection. If you don’t get one, you may have a problem with blood flow to your penis. .

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Psychogenic ED was thought to be the most common cause of ED, however, psychologic causes often coexist with physical or functional causes of ED.
While there’s limited research on how ED affects different races, a study published in the Journal of Sexual Medicine showed that Black Americans may be slightly more likely to suffer from ED than white Americans or Hispanic Americans.

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FDA: "Hidden Risks of Erectile Dysfunction 'Treatments' Sold Online," "FDA Approves Stendra for Erectile Dysfunction."
Bullet point: Ageing and comorbidities as well as polypharmacy factor greatly influence the development of ED.

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“Street” drugs can dampen a man’s feelings of arousal as well as other sensations. Illicit drugs can take away the pleasure of sex and make a man impotent. Some men use drugs to cope with other issues that could be the root of their penile dysfunction. Using drugs only compounds a man’s difficulty in achieving and maintaining erections.

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The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater.

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    If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.

    In men, Kegel exercises can help with erectile dysfunction (ED) and enhance sexual performance. One study of men with ED found that after 6 months of performing Kegel exercises, 40% of men regained normal erectile function. Helping prevent incontinence (which can be important after prostate surgery) Longer time between bathroom visits Fewer “accidents” and leaking Drier underwear Preventing accidental passage of gas or stool Bulbocavernosus (BC) muscle Squeezes semen or urine out of the urethra Squeezes more blood into the end of the penis This is the main muscle used when performing Kegels Pubococcygeus (PC) muscle Plays a role in urination and bowel movements Forms a large part of the pelvic floor, supporting lower organs Contracts during orgasm Iliococcygeus (IC) muscle Forms part of the strength of the pelvic floor Pulls the anus back up after a bowel movement
    The prostate gland is located just below the bladder and is surrounded by nerves and blood vessels. These nerves and blood vessels are needed to achieve a normal erection. Much research has been done to understand where these nerves are located and how to prevent them from getting damaged during surgery or other treatments.

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    As with surgery, the older you are, the more likely it is you will have problems with erections. And men with heart or blood vessel disease, diabetes, or who have smoked heavily seem to be at greater risk for erection problems. This is because their arteries may already be damaged before radiation treatment. Doctors are looking at whether early penile rehabilitation could help after radiation therapy, too. (Penile rehabilitation is discussed above, in the surgery section.)

    Erections that are too soft for sex.Erections that are don’t last long enough for sex.An inability to get an erection.
    To properly strengthen them, leading academic medical centre Mayo Clinic recommends doing three sets of 10 repetitions daily.

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    Worries about self-image and performance can sometimes lead to erection problems, too. Instead of letting go and feeling excited, a man may focus on whether he will be able to function, and fear of failure might make it happen. He may blame the resulting problem on his medical condition, even though he might be able to have an erection if he were able to relax.
    AntidepressantsBlood pressure medicines (especially beta-blockers)Heart medicines, such as digoxinSleeping pillsSome peptic ulcer medicines

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    ED becomes a concern when a man has persistent problems getting or keeping an erection. But how do you know for sure? And what are the major symptoms of ED?

    Exercise may be the ticket to a more active sex life, but we’re talking about regular cardio and strength workouts, not targeted “penis exercises.” Research shows that even a little bit of physical activity — the equivalent of walking 30 minutes a day a few times a week — may lower the risk of erectile dysfunction.
    Studies show about 5 percent of men who are 40 years old have full-blown ED, and that percentage jumps to 15 percent for men who are 70.

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Unlike the other PDE5 inhibitors, sildenafil (Viagra) may affect another phosphodiesterase enzyme in the eye, causing transient abnormal vision (a bluish hue or brightness).

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A German study found that 69% of men involved in a sleep apnea study also suffered from ED. Disruptions to breathing during sleep affect oxygen levels in the blood, which can cause problems generating an erection. Lack of sleep also disrupts hormone production.

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Also, it is important to remember that there are psychogenic issues such as performance-related issues, traumatic past experiences, relationship problems, anxiety, depression and stress that can certainly cause or be considered a comorbid condition contributing to ED.

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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.

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