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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. "It has a long way to go, but the researchers have basically shown they can take cells from an organ, culture them, put them back in and have them be functional," McCullough said. "This is especially impressive because the penis is an organ that's a very sensitive hydraulic pump, so to speak. During an erection, blood has to flow into the organ. The organ then has to expand and then shut down the drainage so the blood doesn't flow back out. And all of these things are very interrelated." 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When the endothelium in these blood vessels doesn�t respond well to the release of nitric oxide (a key part of the chain reaction that allows blood to flow as needed), then blood doesn�t flow into organs, including the penis. In one Hong Kong-based study involving 2,306 men with type-2 diabetes, slightly more than one fourth of the subjects had erectile dysfunction at the start of the study, and none of the participants had any signs or history of heart disease, stroke or vascular disease. After four years, 123 of these men either experienced a heart attack, died from heart disease, developed chest pain caused by clogged arteries, or needed bypass surgery or a catheter procedure to restore blood flow to the heart. Men who had erectile dysfunction at the beginning of the study were much more likely to experience one of these coronary heart disease (CHD) events. A statistical analysis revealed that out of every 1,000 diabetic men with erectile dysfunction, 19.7 could be expected to experience a CHD event each year, as compared to only 9.5 of 1,000 diabetic men without erectile dysfunction. After a complete analysis of many other factors, the study concluded that erectile dysfunction is an early warning sign for heart disease and that it indicated a 58% increase in the risk for CHD. Medical Treatment Oral Medication Oral medications used to treat erectile dysfunction include selective enzyme inhibitors (e.g., sildenafil [Viagra�], vardenafil HCl [Levitra�], tadalafil [Cialis�]) and yohimbine (Yohimbine�, Yocon�). In fact, many medications have ED as a side effect, but �hypertensive drugs are classically the worst,� says Nehra. However, he emphasizes, you don�t have to endure this side effect. Talk to your urologist about medications that will counter ED without affecting your blood pressure meds. New nerve-sparing techniques aimed at lowering the incidence of impotence to 40% to 60% are now being developed and used in these surgeries. Temporary impotence is also associated with these procedures, even those in which nerve-sparing techniques were used. It can take as long as 6 to 18 months for full erections to return. viagra online canada Curb your vices. If scientific evidence and public service announcements haven't convinced you to stop smoking or abusing drugs, maybe a desire to avoid erectile dysfunction will. By contacting your doctor they'll often check you to determine if you would be a viable candidate for popular erectile dysfunction medication. These medicine don't seem to be simply prescribed to older men; it can be for men of all ages. During a period of four years, 123 men had a heart attack, died from heart disease, experienced chest pain due to clogged arteries, or were in need of a heart bypass or cardiac catheterisation. The men with erectile dysfunction were twice as likely to end up in the group who had heart problems than those who did not have sexual problems. The term "erectile dysfunction" can mean the inability to achieve erection, an inconsistent ability to do so, or the ability to achieve only brief erections. These various definitions make estimating the incidence of erectile dysfunction difficult. According to the National Institutes of Health in 2002, an estimated 15 million to 30 million men in the United States experience chronic erectile dysfunction. Introduction.? The Men's Attitudes to Life Events and Sexuality (MALES) study assessed the prevalence and correlates of erectile dysfunction, and examined men's attitudes and behavior in relation to this dysfunction. Aim.? viagra online