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Because of its unique locally acting mechanism of potentiating the physiologic response to sexual arousal, sildenafil is effective in men with erectile dysfunction of organic, psychogenic or combined causes. The use of sildenafil in women is under study but has not yet been approved.
angiographic embolization, erectile dysfunction, high-flow priapism, perineal injury
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Liver and kidney function tests: These blood tests may indicate whether ED may be due to your kidneys or liver functioning improperly.
Three mechanisms trigger these vascular changes: psychogenic, reflexogenic and centrally originated (nocturnal erections). Psychogenic erections occur through stimulatory pathways (e.g., sound, smell, sight and touch) that travel from the spinal erection centres (T11–L2 and S2–S4) and induce a dopaminergic initiation of erection from the medial pre-optic area.17 Reflexogenic erections, induced by direct genital stimulation, send ascending messages to the central erection centres and direct messages to the autonomic nuclei, which explains residual erectile activity in patients with upper spinal cord injuries. Nocturnal erections, initiated in the pontine reticular formation and amygdalae, are seen during REM sleep and are believed to be caused by a relative decrease in sympathetic inhibition with augmentation of the pro-erectile centres.
However, "The distance between biomedical specialties that might once have been bridged mainly by researchers and specialized clinicians now is negotiated mainly by the patients themselves, since their knowledge sets expand and intertwine over time," she wrote.
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Nocturnal penile tumescence (NPT) to check for normal nighttime erections
Duplex ultrasound: This is perhaps the best test for evaluating ED. An ultrasound uses high-frequency sound waves to take "pictures" of the body's tissues. For people with ED, an ultrasound may be used to evaluate blood flow and check for signs of a venous leak, artherosclerosis or tissue scarring. This test is performed both while the penis is erect (usually induced by an injection of a drug that stimulates erection) and also while it is soft.
Vardenafil is generally well tolerated with only mild side effects. These side effects include headache, flushing, nasal congestion, dyspepsia, body aches, dizziness, nausea, and increased blood levels of the muscle enzyme creatine kinase.
While there are medications that can help treat erectile dysfunction, both Mydlo and Lipshultz advocated a healthy lifestyle for maintaining good sexual health.
"For this study we took the perspective of a doctor who may worry that prescribing erectile-dysfunction drugs to patients could contribute to the spread of HIV. The findings from this study should provide some reassurance to health-care providers that erectile-dysfunction drugs appear to be prescribed responsibly and used responsibly," Dr. Robert Cook, an associate professor at the University of Florida and lead researcher of the new study, said in a news release.
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