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"But we found that sexual function wasn't any worse than when patients got radiation in the conventional high-dose way," he said.
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Oral agents that act peripherally to induce smooth muscle relaxation of the corpora cavernosa. The most commonly used agents are sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). Sildenafil was the first in this series of PDE inhibitors. These agents rely on the role of NO in inducing vasodilatation. NO relaxes smooth muscle by stimulating guanylyl cyclase activity, which raises the intracellular concentrations of the cyclic nucleotide cGMP, which, in turn, induces vasodilation.
Vorona said another sleep disorder -- sleep apnea -- also has been linked to erectile dysfunction. And patients with erectile problems appear to do better when their sleep apnea is treated, he said.
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PSA testing got a major lift from an endorsement by the American Cancer Society which has a history of overselling the value of early detection and advising the public to seek tests before their safety and efficacy has been established. Medical organizations like the American College of Physicians and the U.S. Preventive Services Task Force that carefully search the scientific evidence before making screening recommendations have refused to endorse the PSA test. By the time the American Cancer Society tempered its endorsement in 1997, the test had already worked its way into standard medical practice, and one survey showed that half the men over age 65 reported having had a PSA. Not many men, even if fully informed, can walk away from a cancer diagnosis and choose the watchful waiting option that should be offered. Worse, some men dont even know theyve had a PSA. It is often thrown in with usual blood work during a routine physical.
Dealing with erectile dysfunction can be difficult on a relationship. But, sexual intercourse is not the only way to be intimate with your partner. There are sexual and non-sexual ways to remain close. Here are some tips.
"If a woman can just manage to not feel personally wounded by ED, if she can get in touch with her kindness, and her intuitive, nurturing side and follow those instincts, she'll very likely know all the right things to do and say to keep that vital communication going and keep the intimacy alive," says Foley.
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Treatments include psychotherapy, adopting a healthy lifestyle, oral PDE5 inhibitors (Viagra, Levitra, and Cialis), intraurethral medications, intracavernosa injections, vacuum devices, surgery, and working with doctors to avoid medications that can impair erectile function.
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"Animal studies have already indicated that you may be able to achieve as much or more with a single dose of radiation than with a protracted course," Scardino noted. "So, the big question is, are you going to find more complications as a result of this kind of a shift in dosage? Now, cutting back from seven and a half weeks to five weeks is a slight move in this direction, but they found no difference in sexual side effects, and that's valuable. And I certainly think we'll be seeing a lot more research in this area."
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Angiography is useful if the patient is a potential candidate for some type of vascular surgery. Young men with traumatic vascular injuries resulting in ED are candidates for this study because they may qualify for a vascular reconstruction
The causes of erectile dysfunction include aging, high blood pressure, diabetes mellitus, cigarette smoking, atherosclerosis, depression, nerve or spinal cord damage, medication side effects, alcoholism or other substance abuse, and low testosterone levels.
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