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70-80% of ED is related to poor arterial blood flow to the penis which all these comorbid conditions above may contribute to in some degree.

Anatomical variances/Psychosocial factors: Sometimes, variances in anatomy can impair a functional erection.

Many younger men presenting with ED may have abnormal venous outflow from the penis, resulting in loss of erection during sexual activity.

Psychosocial factors including depression or anxiety can also cause ED and seems especially more prominent in younger men.

Lifestyle choices: Additionally, there are strong associations between certain lifestyle choices and ED. Smoking and a sedentary life style increases ED prevalence dramatically. Luckily, lifestyle modifications can dramatically decrease a man’s chances of developing ED or progressing their existing symptoms. Sufficient exercise has been shown to decrease ED occurence.

In fact, a well-supported study demonstrated that weight loss and increased activity can actually reverse ED in obese men without the help of medications. Sexual Activity: The amount of sexual activity also appears to impact ED prevalence rates.

In one study, men having decreased sexual intercourse (average of less than once per week) had twice the rates of ED compared to men having more frequent sexual intercourse (at least once a week).

Sleep Apnea/RLS: Interestingly, sleep apnea appears to be a risk factor for ED. Treatment with CPAP (continuous positive airway pressure) may improve ED symptoms.

Although not fully investigated, restless leg syndrome (RLS) appears also to increase the rates of ED in men.

It is still unclear how treatment for RLS impacts ED.

Medications: Certain medications may increase ED rates in men.

It is estimated that medications may be at least partially responsible sildenafil 25 mg price for 25% of ED cases in men. Some of the most common medications that can cause ED include: antidepressants, sympathetic blockers (clonidine,

methyldopa

A variety of other medications are also associated with ED. Alcohol, cocaine, marijuana, and other drugs also can exacerbate ED symptoms. Biking/Endocrine/Low Testosterone: Excessive bicycling, endocrine disorders, and low testosterone are also risk factors for ED. Bicycling places pressure on the perineal nerves, which in excessive amounts, can cause numbness of the penis and impotence. Others: Other potential causes of ED include

systemic

To summarize, there are many different factors that can cause or contribute to ED. Some of the strongest contributors, such as comorbid conditions, can be modified and controlled with lifestyle changes. Most common however, ED causes are multifactorial and complex. Our urology team is here to work with you to resolve your ED and improve your sexual function. How We Diagnose ED: As described above, there are many risk factors and causes for ED.

Therefore, our team investigates the potential causes for each patient thoroughly and independently to ensure the best possible outcome.

Our work up for ED may include: Medical and sexual history Physical exam Psychological assessment Basic labs.

Treatment Options: Treatment options may vary depending on the presumed cause of your ED.

Our team will work with and may suggest the following treatments: Oral medications, such as Viagra, Cialis, or Levitra Vacuum devices Penile self-injection therapy Lifestyle modifications Surgical procedures. Erectile dysfunction (also known as impotence, or ED) is the inability to get and keep an erection firm enough for sex. A practical approach to treating ED —similar to the strategy for most medical issues — starts with a medical history, physical examination and basic lab tests. More extensive testing sildenafil 25 mg tablet price may be suggested depending on the individual.

If the evaluation indicates that the ED is psychological or emotional in origin, referral to a qualified psychologist, psychiatrist or sexual counselor will be the next step. If the lab results indicate low testosterone, additional hormone tests will be done to determine the precise cause of the low testosterone, then a treatment aimed at normalizing the levels will be suggested.

If testing shows undiagnosed or poorly controlled diabetes or a risky lipid and cholesterol profile, a referral to another medical professional will be necessary.

Although ED treatment is tailored to the individual patient, there are four general paths of treatment for ED: 1. A healthy lifestyle can “reverse” ED naturally, as opposed to “managing” it.

Since ED can often be considered a “chronic disease,” healthy lifestyle choices can reverse it, prevent it sildenafil price 50 mg from getting worse, or even prevent it altogether. Since sexual function is based on many body parts working together, this approach is to nurture every cell, tissue and organ in the body.The goal is to achieve a healthy weight, adopt a healthy diet, exercise regularly, get enough good quality sleep, stop using tobacco, consume alcohol in moderation, and reduce stress. Aside from general cardio and strength exercises, specific pelvic floor muscle exercises (“man-Kegels”) are beneficial to improve the strength, power and endurance of the penile “rigidity” muscles.

If a healthy lifestyle can be adopted, sexual function will often improve dramatically, as well as overall health improvements. Since many medications have side effects that negatively impact sexual function, a bonus of lifestyle improvement is potentially needing lower dosages or perhaps eliminating medications (blood pressure, cholesterol, diabetes), which can result in further improving sexual function.

It’s my opinion that oral ED medications should be reserved for when lifestyle optimization fails to improve sexual issues. This may be at odds with some physicians who find it convenient to simply prescribe meds, and with some patients who want a quick and easy fix. However, as good as Viagra, Levitra, Cialis and Stendra may be, they are expensive, have side effects, are not effective for every patient and cannot be used by everyone, as there are medical situations and certain medications that may prevent their use. In this category, I also include mechanical, non-pharmacological, non-surgical

devices

Low-intensity shockwave therapy is an exciting new treatment option that uses acoustic energy to cause mechanical stress and microtrauma to erectile tissues. This stimulates the growth of new blood vessels and nerve fibers and potentially enables penile tissue to regain the ability for spontaneous erection.

Vacuum suction devices are mechanical means of producing an erection in which the penis is placed within a plastic cylinder that is connected to a manual or battery-powered vacuum. Negative pressure engorges the penis with blood and a constriction band is temporarily placed around the base of the penis to maintain the erection.

80% of men can achieve good rigidity, but many do not continue using the device because of its cumbersome nature. Venous constriction devices are used in conjunction with the vacuum suction devices to trap blood in the penis and help maintain the erection. They also can be used without the suction devices in certain circumstances.

Men who find these beneficial are usually able to obtain a reasonable quality rigid erection but tend to lose it prematurely.

Vibration devices were traditionally employed to provoke ejaculation in men with spinal cord injuries who desired to father children.

Subsequently, they have achieved broader utility and are now also used to facilitate erections in men with ED. Dual-armed vibratory stimulation of the penile shaft is capable of inducing an erection and ultimately ejaculation.

Penile traction devices use mechanical pulling forces to lengthen and/or straighten the penis to manage or prevent penile shortening and angulation.

Vasodilator urethral suppositories and penile injections.

These are suppositories and injections that increase penile blood flow and induce erections. (Medical urethral system for erection) is a small medicated vasodilator pellet available in a variety of different dosages that is placed within the urinary channel of the penis after urinating.

Absorption occurs through the urethra into the adjacent erectile chambers, inducing increased penile blood flow and potentially an erection.

About 40% of men can achieve rigidity, but it is often inconsistent.

Prostaglandin E1 is injected directly into one of the erectile chambers of the penis, resulting in increased blood flow and erectile rigidity.

After being taught the technique of self-injection, vasodilator medications can be used on demand, resulting in rigid and durable

sildenafil

Penile prostheses

can

The semi-rigid device is a simple one-piece flexible rod, one of which is implanted within each of the paired erectile chambers. The penis is bent up sildenafil 25 mg price for sexual intercourse and down for concealment.

The inflatable device is a three-piece unit that is capable of inflation and deflation.

Inflatable inner tubes are implanted within the erectile chambers, a fluid reservoir is implanted behind the pubic bone or abdominal muscles and a control pump in the scrotum, adjacent to the testes.

When the patient desires an erection, he pumps the control pump several times, which transfers fluid from the reservoir to the inflatable inner tubes, creating a hydraulic erection that can be used for as long as desired. When the sexual act is completed, the device is deflated via the control pump, transferring fluid back to the reservoir and restoring a flaccid state.

Implantica’s Solution, PotencyFlow® Implantica’s PotencyFlow® is subject to further development and approval process.

Although Viagra type of drugs has improved the situation for the around 150 million men suffering from Erectile Dysfunction, only 50% are able to use these drugs with a successful result. PotencyFlow® is designed to treat impotence by hindering blood leakage from the penis during erection.

The most common cause for erectile dysfunction is leakage of blood from the erectile system since pressurized blood causes the erection.

Implantica’s PotencyFlow® is designed to help these patients

suffering

veins

The device, which will use Implantica’s shared wireless energy platform, will be controlled wirelessly by a remote control or a push button under the skin resulting in a

smooth

The device is designed to create erection by stimulation followed by restricting the blood flow leaving the penis using a penile blood flow restriction cuff, preventing the leak of the filling blood in the penis, thereby treating erectile dysfunction. The options available today are reconstructive surgery (often with poor long-term result) or a penile implant. Unlike penile implants, PotencyFlow® will not damage the penile erectile tissue and will therefore be preferred entry procedure

especially