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Erectile Dysfunction or Impotence
ED Treatments, Part II Other, more invasive treatments for Erectile Dysfunction are: Self-injection involves using a short needle to inject medication through the side of the penis directly into the corpus cavernosum, which produces an erection that lasts from 30 minutes to several hours. Prostaglandin (alprostadil, Caverject, Edex), and phentolamine (Regitine) produce results similar to Viagra but are localized in the penis after injection. They cause vascular dilation and a relaxation of smooth muscle. Prostaglandin is the only substance currently approved for erectile dysfunction treatment. Phentolamine is a heart medication with similar effects used by some physicians to treat impotence. These drugs have been shown to produce erections in 80% of men who inject them. Some men claim that they produce erections that feel natural and improve sex. The injections are relatively painless and create an erection that begins about 5 to 15 minutes after the injection. Side effects of self-injections:
Urethral suppositories These are alternatives to injections; these contain prostaglandin (aprostadil) for example Muse (Medicated Urethral System for Erections). Using a hand-held delivery device, a man inserts a prostaglandin pellet through the meatus (penis opening) into the urethra. Prostaglandin is absorbed through the urethral mucosa and into the surrounding erectile tissue. It is available with a prescription, is well tolerated, and may improve erections in 60% of men who use it. A word of caution regarding urethral suppositories - in addition to the side effects associated with injecting aprostadil, pain in the penis and perineum (area between scrotum and rectum) may occur with suppository use. Vacuum Devices Vacuum devices (commonly known as "Swedish Pumps") work best in men who are able to achieve partial erections on their own. They are easy to use at home, require no other procedure, and typically improve erections regardless of the cause of impotence. Some men experience a numbing feeling afterwards. Since the penis is flaccid between the ring and the body, the erection may be somewhat floppy. Vacuum devices work by manually creating an erection. Penile Implants Surgery usually has one of three goals:
Implanted devices, known as prostheses, can restore erection in many men with ED. Malleable implants usually consist of paired rods, which are inserted surgically into the corpora cavernosa. The user manually adjusts the position of the penis and, therefore, the rods. Adjustment does not affect the width or length of the penis. Inflatable implants consist of paired cylinders, which are surgically inserted inside the penis and can be expanded using pressurized fluid. Inflatable implants can expand the length and width of the penis somewhat. They also leave the penis in a more natural state when not inflated.
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