Drug Treatment of Erectile Dysfunction

Erectile dysfunction is one of three types of dysfunction in males. Most often the cause is organic and the erectile dysfunction is due to inadequate vascular supply to the penis, impaired stimulation of the blood vessels in the pelvis or penis, or impared central nervous system perception of stimuli. Effective drug Oxycodone withdrawal symptoms is available.

The drug of first choice is an oral phosphodiesterase inhibitor (Viagra, Levitra or cialis), which has a convenient route of administration, relatively safe, and effective in many patients independent of the cause of the erectile dysfunction. However, phosphodiesterase inhibitors (Viagra, Levitra, or Cialis) should not be use in patients with poorly controlled hypertension, unstable angina, moderate-severe congestive heart failure, heart attack or stroke victum in the immediate two weeks period prior to the start of the phosphodiesterase inhibitor (Viagra, Levitra, or Cialis).

Furthermore, phosphodiesterase inhibitors are inappropriate for use in patients who are also taking nitrates by any route of administration. Vacuum erection devices are an effective non-drug alternative,: however, they are not effective to spontaneous intercourse. Intracavernosal alprostadil (Caverject or Edex) injection is effective, but does require the patient to learn and use surgical cleanliness technique. Many patients may hesitate to use injection therapy. Also, long term observational studies show that the drop out rate among patients increases over time due to the perceived inconvenience and lack of spontaneity of infection therapy. Intraurethal alprostadil (a medication-containing pellet is inserted into the uretha using a unique intraurethal installation device, called MUSE or medication urethal system for erection) is less effective than injection into the penis and is therefore considered a third or fourth line agent.

Penile prosthesis should be reserved for patients who do not respond to , cannot tolerate, or choose not to use drug therapy or a vacuum erection device. A penile prosthesis requires a surgical procedure and anesthesia and can be associated with immediate or long term post-operative complications.

 

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