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I m afraid that there is something wrong with my cargo, so I ll come over and check it out every hour. Give guidance, not just Viagra, to men with diabetes and related impotence. Diabetic men with erectile dysfunction might consider a prescription for a drug like Viagra to be a permanent cure for a temporary issue: Take a pill, problem solved. But the truth, a leading urologist says, is entirely different. “If a diabetic patient has erectile dysfunction, it’s not enough to provide Viagra [sildenafil] or Cialis [tadalafil] and then send him on his merry way,” J. Francois Eid, MD, a New York City urologist, said at the annual meeting of the American Association of Diabetes Educators. “It’s important to let individuals know the drug has not cured the erectile dysfunction. If patients don’t take care of the diabetes, the erectile dysfunction progresses.” In an interview, Dr. Eid shared several messages for medical professionals who treat men with diabetes and related erectile dysfunction: • Diabetes has “devastating” effects on the penis, and may even cause it to shrink. • Long-term uncontrolled diabetes can make ED permanent. • While ED drugs often fail in men with diabetes, several other options exist; and penis implants may provide significant relief. An estimated 50%-75% of men with diabetes experience from some degree of ED, which is thought to be three times more common in diabetic men than other men, according to Dr. “Diabetes has a devastating effect on the muscle tissue inside the penis,” he said. “All the tiny little arteries that feed blood to the muscle get occluded. Little by little, the muscle inside the penis shrinks.” Indeed, some diabetics with ED complain that their penises have shrunk, he said. Diabetic damage doesn’t stop with these small vessels, he said. “You really have two parallel situations: You need blood flow that feeds the muscle of the penis, and you need an artery dedicated to bringing blood rapidly when a man becomes aroused and wants to be sexually active,” he said. They’ll say ‘I can get a partial erection, but I can’t maintain it.’ ” What comes after an ED diagnosis in diabetic patients? Eid will instantly refer these men to a cardiologist. “If a patient has diabetes and is newly diagnosed, a significant portion of these men are going to develop coronary artery disease in the next 2-3 years,” he said. “One of the things we do is recommend is that they see a cardiologist and perhaps have a stress test or some sort of evaluation.” Dr. Eid also urges these patients to treat their diabetes in order to avoid developing ED for life. “They need to manage their diabetes and make sure they control it so the ED will not progress and will stabilize, as a result,” he said. “If the diabetes is controlled after the patient is first diagnosed, then the erections will come back. But if the patient has diabetes for many years, and suddenly decides it’s time to control it, they cannot prevent the damage that’s already been done.” As for treatments, patients with diabetes and related ED should begin with medications like sildenafil and tadalafil, he recommended. But research findings suggest that the drugs will fail in half of men with type 2 diabetes, he said. Other options include penile self-injections, vacuum devices, and penile implants. The injections “can work well and are painless, but men detest having to inject themselves before sexual activity,” Dr. And he said men rarely have success using vacuum devices, which are available over the counter. By contrast, penis implants can successfully treat erectile dysfunction in many cases, Dr. Men trigger erections by squeezing a pump that is implanted into the scrotum. Fluid then flows from an implanted reservoir into a cylinder implanted in the penis. Men are often pleased by penis implants because they can have sex spontaneously without having to plan for it ahead of time, as required by medications. Eid receives or has received research support/grants from American Medical Systems, Coloplast, Lilly ICOS, Bayer, Vivus, Pharmacia-Upjohn, and Pfizer. He is or was a consultant and on the speakers bureau for Coloplast, American Medical Systems, Lilly ICOS, Bayer and Pfizer. Erectile Dysfunction Drug Also Helps Men Ejaculate and Orgasm. New Study Shows Cialis Assists Men with Problems Ejaculating and Achieving an Orgasm, Despite the Severity of Their ED. NEW YORK (January 30, 2013) — New data suggests the erectile dysfunction (ED) drug Cialis may also be beneficial in helping men who have problems with ejaculation and orgasm, report researchers from NewYork-Presbyterian Hospital/Weill Cornell Medical Center in the February issue of the British Journal of Urology International. Cialis is currently approved for the treatment of ED, benign prostate hypertrophy (BPH) and for treatment of men with both conditions. Their study, a meta-analysis of 17 double-blind, placebo-controlled clinical trials of men with ED, is the first to analyze the benefit an agent like Cialis offers for common issues of sexual dysfunction that may have little to do with ED. Their study concluded that approximately 70 percent of men who used Cialis during sexual activity for 12 weeks were able to ejaculate most of the time and to reach orgasm, compared to 30 percent in the placebo group. Also, these benefits from the drug were seen despite the level of a man's ED severity. "There are many men who have, at most, very mild problems achieving an erection but who cannot easily ejaculate," says the study's lead author, Dr. Darius Paduch, a urologist and male sexual medicine specialist at NewYork-Presbyterian/Weill Cornell and director of Sexual Health and Medicine at Weill Cornell Medical College. "Our study shows Cialis works very well for these men with problems ejaculating." Dr. Paduch says up to 18 percent of men have a normal erection but don't ejaculate, or take a long time to do so. He adds that while the issue may be more prevalent in the elderly, it affects men of all ages. "Many of my patients are young men who want to have children and so they want to solve their issues with ejaculation," says Dr. Paduch, who is also an associate professor of urology and reproductive medicine at Weill Cornell. Every internist faces this problem in his male patients and has no options to offer. Our study shows Cialis may help." Men with No ED Can Have Sexual Dysfunction. Paduch and his colleagues have long researched issues of sexual dysfunction that extend beyond ED. "Erectile dysfunction isn't the whole story, by any means," he says. The largest analysis to date of orgasmic and ejaculatory dysfunction, also published in the British Journal of Urology International, followed nearly 12,130 men with mild to severe ED and found that 65 percent of the participants were unable to have an orgasm and 58 percent had problems with ejaculation. Even men with no or very minimal ED reported poor ejaculatory function (17 percent) and poor ability to have an orgasm (22 percent). Paduch pointed out that approximately 30 million American men — half of all men aged 40 to 70 — have trouble achieving or sustaining an erection. "While medications like Viagra and Cialis have been successful in helping many of these men, our research suggests there are other common sexual issues that remain largely unaddressed," he said in 2011. Non-erectile sexual dysfunction is underreported and undertreated due to social stigma and, in particular, misunderstandings about the physiology of male sexual response and orgasmic dysfunction, Dr. "For decades it was believed that only women had problems with orgasm, but our research shows that orgasmic dysfunction could be as prevalent among men as it is among women." In this new study, Dr. Paduch and his colleagues examined data from 17 placebo-controlled 12-week trials of Cialis, given at different doses. These studies included 3,581 participants with a mean age of 54.9, including 1,512 men with severe ejaculatory dysfunction (EJD) and 1,812 with severe orgasmic dysfunction (OD). In some cases, patients with one or both of these conditions reported only mild or moderate ED. The researchers examined the study participants' responses on questionnaires about the effect Cialis had on ED, EJD, and OD, among other measures of sexual satisfaction. The original questionnaire was primarily focused on the effects of Cialis on ED, but provided valuable additional information. They found that treatment with Cialis (10 or 20 milligrams taken as needed) was associated with significant increase in ejaculatory and orgasmic function across all levels of severity of ED, EJD and OD, compared to use of a placebo agent. For example, 66 percent of men with severe EJD and 66 percent with severe OD who used Cialis reported improved ejaculatory function, compared with 36 percent and 35 percent, respectively, in the placebo group. Also, patients with moderate dysfunction also experienced significant improvements with Cialis, Dr. "More study is needed, but we are hopeful our findings may lead to a treatment for many men who cannot now achieve sexual satisfaction," Dr. Other study co-authors include Alexander Bolyakov, a research associate in the Department of Urology at Weill Cornell, and Paula K. Polzer and Steven Watts, the study's senior investigator, both of Lilly Research Laboratories of Eli Lilly. This research study was funded by Eli Lilly and Company, the manufacturer of Cialis. Paduch and Bolyakov are funded study investigators and consultants for Eli Lilly. In addition, Polzer and Watts are employees of, and minor shareholders in, Eli Lilly. This study was selected by BJUI's Editor-in-Chief as the "Article of the Week" with Dr. Paduch also featured in an online video discussing his research. We’ve all heard those warnings at the end of Viagra, Cialis or Levitra commercials about contacting your doctor if you have an erection that lasts longer than four hours (prompting many a joker to declare, “the hell with the doctor, I’m calling my friends!”). But priapism, a prolonged erection unaccompanied by sexual desire and unaffected by orgasm, is actually no laughing matter. “A prolonged erection is usually painful,” says Dr. Ira Sharlip, clinical professor of urology at the University of California at San Francisco and spokesperson for the American Urological Association. “Men usually know something’s wrong even cialis prices near me if they’ve never heard of this condition, and almost always come in for care because of the pain. There are some men who don’t want to go to the doctor or an emergency room, but they should know that it’s a potentially serious condition which can result in permanent erectile dysfunction if it’s not taken care of.” Named for Priapus, the Greek god of fertility who sported an oversized, eternally-erect penis (so large, in fact, he used it to frighten away anyone who tried to plunder his gardens), priapism brought on by erectile dysfunction drugs is extremely rare. “The [Food and Drug Administration] requires a warning in the package insert because of the potential complication, but I’ve been prescribing Viagra for 10 years to many thousands of men and have never seen a case,” says Sharlip, who maintains a private urology practice in San Francisco. “It does happen even in men who aren’t taking erection drugs – I’ve taken care of the problem at the emergency room at the medical center where I work — but it’s really rare. So rare, that I don’t discuss this as a potential complication with my patients.” This site is protected by recaptcha Privacy Policy | Terms of Service. Rough statistics from the FDA’s adverse event reporting system (AERS) regarding the erectile dysfunction (ED) drugs Viagra, Cialis and Levitra show a total of just 93 cases of prolonged erection greater than four hours or painful erection greater than six hours (priapism) in all of 2007 — 74 for Viagra, three for Levitra and 16 for Cialis. According to the FDA, physicians are encouraged to report suspected adverse events, although the event may be related to an underlying disease, another drug or simple chance. Priapism is much more commonly seen in conjunction with penile injection therapy (an alternate treatment for ED), blood diseases such as leukemia or sickle-cell anemia, injury or trauma to the penis, spinal cord injuries, or as a side effect to certain drugs such as the antidepressant trazadone. The condition is found in all age groups, including children (usually in association with leukemia). There are also extremely rare cases of priapism in females (known as clitorism). A recent generic cialis cost walmart msnbc.com column dealth with a 70-year-old man who thought he had a form of priapism. To understand priapism, it’s important to first understand the mechanics of an erection, which occurs when the blood vessels of the penis relax and open. ED drugs like Viagra don’t trigger erection — you need some kind of sexual stimulation for that — but they definitely set the stage by increasing enzyme actions in the erection chambers. Once the stage is set (via a little blue pill and a few soft lights, a hint of lingerie, and the musical stylings of Barry White), the spongy tissues along the length of the penis fill with blood and harden and the veins leaving the penis constrict. Unfortunately, in the small percentage of men suffering from priapism, the system goes haywire and they’re unable to get rid of their erection once it shows up.
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