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GORDON F. GREEN, CDR, MC, USNR
Conclusion The researchers conclude that erectile dysfunction in diabetes is due to a selective defect in the NO mechanisms within the PVN. This defect is a loss in the synthetic enzyme for the production of NO within the neurons of the PVN. Restoring this synthetic enzyme may have a significant therapeutic value for diabetic patients with ED.
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In the treated rabbits, tests showed that pressure inside the penis, a key component of an erection, was normal. Other tests showed that blood flow, response to nitric oxide, drainage of the blood after the erection and presence of sperm in the female vagina were also normal. The tissue engineering worked so well that four of 12 females were impregnated by the repaired rabbits, according to the study.
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If this impotence treatment is not successful, what other options might you recommend?
Erectile Dysfunction Article
If the man's life expectancy is low due to old age or other factors, surgery or radiation for prostate cancer might actually do more harm than good, some doctors feel.
Naval Hospital Jacksonville, Jacksonville, Florida Patient information handouts on erectile dysfunction and Viagra, written by the authors of this article, are provided on pages 1169 and 1172.
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Severe heart failure or disease of the heart's valves, for example, aortic stenosis
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"There are lots of different ways to be sexual, and if one way becomes difficult or even impossible, you have to explore, together, the things you can do with each other that are sexually exciting," says Downey.
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Bob Dole, Pitchman for Erectile Dysfunction
Oral sildenafil appears to be safe in the treatment of erectile dysfunction in the real world. It is accepted widely by our patients as first line treatment and is successful in 91% of our patients. At the end of the study period 80% of the patients were willing to continue with sildenafil therapy. In our part of the United Kingdom, there is a large expectation for ED to be treated in the NHS. Of those men eligible for treatment of their ED in the NHS, 30% qualify under the clinical categories and 18% under the 'distress' category. This has implications on the local prescribing policies and resources. Under the current guidelines, only 55% of men with one or more cardiovascular risk factors qualify for treatment in the NHS. The majority of men presenting with ED could be managed in primary care.
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Their study involved 1126 men, between 50 and 70 years of age, without erectile dysfunction in 1994 when they completed a questionnaire that included, among other things, questions about erectile function and medication usage. The questionnaire was then re-administered five years later.
Tens of millions of men worldwide have benefited from oral ED medications such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). However, these medications which belong to a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors have limitations. They can cause systemic side effects that can be serious. These side effects include headache, facial flushing, nasal congestion, upset stomach, abnormal vision as well as isolated reports of hearing and vision loss. Men who've recently suffered a heart attack or stroke or have severe heart disease should use these drugs with caution or not at all. In addition, "an estimated 30 to 50 percent of men with ED do not respond to oral use of PDE5 inhibitors," says senior author Kelvin P. Davies, Ph.D., associate professor of urology at Einstein.
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Drinking too much alcohol, smoking too much and abusing drugs can also cause erectile dysfunction.
Erectile Dysfunction
We would like to thank Drs. Drew Pardoll, Elizabeth Jaffee, Katie Whartenby, Eduardo Sotomayor, Alessia Zoso, and Stephanie Mgebroff for their critical reading of the manuscript and Dr. Michael Lee for his assistance with the Western blot.
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