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DONALD W. SHENENBERGER, LT, MC, USNR Erectile Dysfunction: Supporting Your Partner 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. Healthy smooth muscles and fibrous tissues within the corpora cavernosa, and stress, anxiety, depression, and relationship problems. What should I or my partner do if a severe reaction occurs? brand viagra online sale As challenging as erectile dysfunction is on its own, it can also be a warning sign for more serious problems, such as heart disease. Men who experience even mild erectile dysfunction (ED) have about a 25 percent greater risk of heart disease, including heart attack and stroke, than their peers. This means that, for some men, erectile dysfunction is a stronger predictor of heart disease risk than family history, smoking, or high cholesterol levels. And the more severe your ED, the greater your risk of heart disease-related events. Set realistic goals and expectations. The physical examination should focus on the vascular, neurological and endocrine systems.28,31 Testes size should be noted and the penis shaft examined to rule out a penile deformity (Peyronie's disease). With respect to laboratory investigations, recommendations vary,30,31 and investigations should follow clinical suspicion of specific disorders. Hemoglobin A1c and serum glucose may be measured to detect occult diabetes, and a lipid screen performed to assess the presence of dyslipidemia. Hormonal screening is controversial; however, it is reasonable to measure testosterone levels in the face of erectile dysfunction combined with loss of libido.28 Patients in whom hyper- or hypothyroidism is suspected should have their thyroid-stimulating hormone level checked.30 Requires refrigeration Many specific therapeutic options are now available for erectile dysfunction, with varying degrees of patient satisfaction. These include established nonpharmacologic treatments such as vacuum erection devices, penile prostheses or penile revascularization. Referral to a psychologist or psychiatrist with expertise in sexual dysfunction may be beneficial for patients with psychogenic erectile dysfunction.8 Currently available pharmacotherapeutic agents are compared in Table 3. Documented hypersensitivity; concurrent or intermittent use organic nitrates in any form Peyronie's disease is a rare inflammatory condition that causes scarring of erectile tissue. Scarring produces curvature of the penis that can interfere with sexual function and cause painful erections. Accepted 22 December 2005 A comparison of satisfaction rates and ED in subjects treated with sildenafil, intracavernous PGE1 (alprostadil), and penile implant surgery was performed by Rajpurkar and Dhabuwala in 138 men with ED. This was a nonrandomized study in which all subjects were initially offered sildenafil. The mean follow-up was 19.54 months, and questionnaires were used to obtain the data. Their conclusions were that men with a penile implant had significantly better erectile function and satisfaction. Return to top Erectile Dysfunction Anxiety