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The inflatable penile prosthesis consists of two cylinders -- a reservoir and a pump -- which are placed surgically in the body. The two cylinders are inserted in the penis and connected by tubing to a separate reservoir of fluid. The reservoir is implanted under the groin muscles. A pump is also connected to the system and sits under the loose skin of the scrotal sac, between the testicles.
Of the 99 men reviewed, the optimal dose for achieving erection satisfactory for sexual intercourse was: 25 mg � 6 (6.1%), 50 mg � 44 (44.4%), 75 mg � 1 (1%) and 100 mg � 38 (38.4%). The side effects most commonly encountered were headache (24%), flushing (16%), dyspepsia (12%), nasal congestion (10%), abnormal vision (5%), thirst (2%) and dazed feeling (2%). Uncommon side effects included palpitations (1), dizziness (1) and penile pain (1). Severe side effects necessitated withdrawal of Viagra in 2 patients (1 was a 'success' and the other a 'failure'). Out of 53 men who reported lack of side effects at Visit 2, 6 developed some side effects at Visit 3. Conversely, 11 men who had side effects at Visit 2 reported lack of them at Visit 3. There were no changes in the side effect profile between Visit 3 and Visit 4. Four men with Peyronie's disease had used sildenafil � two reported success with therapy while the other two failed. There were 2 isolated reports of prolonged erection (lasting 20 � 30 minutes) that were painless, which did not recur. There were no serious adverse events or deaths recorded during the trial period.
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On the part of the consumer, such advertisements "can engender useful conversations between doctors and patients," Metzl said. "And they can encourage doctors to look at cultural issues."
Vorona said another sleep disorder -- sleep apnea -- also has been linked to erectile dysfunction. And patients with erectile problems appear to do better when their sleep apnea is treated, he said.
Treatment Strategies
Erectile dysfunction, or ED, can be a total inability to achieve erection, an inconsistent ability to do so, or a tendency to sustain only brief erections. These variations make defining ED and estimating its incidence difficult. Estimates range from 15 million to 30 million, depending on the definition used. According to the National Ambulatory Medical Care Survey (NAMCS), for every 1,000 men in the United States, 7.7 physician office visits were made for ED in 1985. By 1999, that rate had nearly tripled to 22.3. The increase happened gradually, presumably as treatments such as vacuum devices and injectable drugs became more widely available and discussing erectile function became accepted. Perhaps the most publicized advance was the introduction of the oral drug sildenafil citrate (Viagra) in March 1998. NAMCS data on new drugs show an estimated 2.6 million mentions of Viagra at physician office visits in 1999, and one-third of those mentions occurred during visits for a diagnosis other than ED.
The answer: it depends. The issue is less actual size than perception of size.
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Recommendation 2: The American College of Physicians recommends that clinicians base the choice of a specific PDE-5 inhibitor on the individual preferences of men with erectile dysfunction, including ease of use, cost of medication, and adverse effects profile (Grade: weak recommendation; low-quality evidence).
Supplements are intended to provide nutritional support. Because a supplement or a recommended dose may not be appropriate for all persons, a physician (i.e., a licensed naturopathic physician or holistic MD or DO) should be consulted before using any product.
This Story High BPA levels linked to male sexual problems
Prostate examination�An enlarged prostate, which can be detected with a digital rectal examination (DRE), can interfere with blood flow and nerve impulses in the penis.
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Erectile dysfunction isn't easy to talk about. Yet some 5% of 40-year-old men and up to 25% of 65-year-old men experience ED. WebMD's experts use plain, explicit language to give you information on erectile dysfunction causes, tests, treatments, and support. Here's where you and your partner can start building a better sex life.
However, Mason said those drugs are still many years and many, many dollars away.
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