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Nearly 1000 years later, the Egyptian Papyrus Ebers, a medical Egyptian document dated 1600 BC, describes a cure for impotence in which baby crocodile hearts were mixed with wood oil and applied topically to the penis.4
The authors thanks Dr. Heinz Schönhofen from Center of Radiology Baden in Switzerland for excellent implementation of CT cavernosography and high quality CT images. 1. NIH Consensus Conference. Impotence. NIH consensus development panel on impotence. Jama. (1993) 270:83–90. doi: 10.1001/jama.270.1.83 2. Nguyen HMT, Gabrielson AT, Hellstrom WJG. Erectile dysfunction in young men-a review of the prevalence and risk factors. Sex Med Rev. (2017) 5:508–20. doi: 10.1016/j.sxmr.2017.05.004 3. Rogers JH, Goldstein I, Kandzari DE, Köhler TS, Stinis CT, Wagner PJ, et al. Zotarolimus-eluting peripheral stents for the treatment of erectile dysfunction in subjects with suboptimal response to phosphodiesterase-5 inhibitors. J Am Coll Cardiol. (2012) 60:2618–27. doi: 10.1016/j.jacc.2012.08.1016 4. Dicks B, Bastuba M, Goldstein I. Penile revascularization–contemporary update. Asian J Androl. (2013) 15:5–9. doi: 10.1038/aja.2012.146 5. Rogers JH, Karimi H, Kao J, Link D, Javidan J, Yamasaki DS, et al. Internal pudendal artery stenoses and erectile dysfunction: correlation with angiographic coronary artery disease. Catheter Cardiovasc Interv. (2010) 76:882–7. doi: 10.1002/ccd.22646 6. Lue TF. Erectile dysfunction. N Engl J Med. (2000) 342:1802–13. doi: 10.1056/NEJM200006153422407 7. Rebonato A, Auci A, Sanguinetti F, Maiettini D, Rossi M, Brunese L, et al. Embolization of the periprostatic venous plexus for erectile dysfunction resulting from venous leakage. J Vasc Interv Radiol. (2014) 25:866–72. doi: 10.1016/j.jvir.2014.01.015 8. Shafik A, Shafik I, El Sibai O, Shafik AA. On the pathogenesis of penile venous leakage: role of the tunica albuginea. BMC Urol. (2007) 7:14. doi: 10.1186/1471-2490-7-14 9. Doppalapudi SK, Wajswol E, Shukla PA, Kolber MK, Singh MK, Kumar A, et al. Endovascular therapy for vasculogenic erectile dysfunction: a systematic review and meta-analysis of arterial and venous therapies. J Vasc Interv Radiol. (2019) 30:1251–8. doi: 10.1016/j.jvir.2019.01.024 10. Diehm N, Marggi S, Ueki Y, Schumacher D, Keo HH, Regli C, et al. Endovascular therapy for erectile dysfunction-who benefits most? insights from a single-center experience. J Endovasc Ther. (2019) 26:181–90. doi: 10.1177/1526602819829903 11. Wespes E. Erectile dysfunction in the ageing man. Curr Opin Urol. (2000) 10:625–8. doi: 10.1097/00042307-200011000-00016 12. Rhoden EL, Teloken C, Sogari PR, Vargas Souto CA. The use of the simplified International Index of Erectile Function (IIEF-5) as a diagnostic tool to study the prevalence of erectile dysfunction. Int J Impot Res. (2002) 14:245–50. doi: 10.1038/sj.ijir.3900859 13. Kaufman JM, Borges FD, Fitch WP III, Geller RA, Gruber MB, Hubbard JG, et al. Evaluation of erectile dysfunction by dynamic infusion cavernosometry and cavernosography (DICC). Multi-institutional study. Urology. (1993) 41:445–51. doi: 10.1016/0090-4295(93)90505-5 14. Gratzke C, Angulo J, Chitaley K, Dai YT, Kim NN, Paick JS, et al. Anatomy, physiology, and pathophysiology of erectile dysfunction. J Sex Med. (2010) 7:445–75. doi: 10.1111/j.1743-6109.2009.01624.x 15. Ye T, Li J, Li L, Yang L. Computed tomography cavernosography combined with volume rendering to observe venous leakage in young patients with erectile dysfunction. Br J Radiol. (2018) 91:20180118. doi: 10.1259/bjr.20180118 16. Katzenwadel A, Popken G, Wetterauer U. Penile venous surgery for cavernosal venous leakage: long-term results and retrospective studies. Urol Int. (1993) 50:71–6. doi: 10.1159/000282455 17. Lewis RW. Venous surgery for impotence. Urol Clin North Am. (1988) 15:115–21. 18. Aschenbach R, Steiner T, Kerl MJ, Zangos S, Basche S, Vogl TJ. Endovascular embolisation therapy in men with erectile impotence due to veno-occlusive dysfunction. Eur J Radiol. (2013) 82:504–7. doi: 10.1016/j.ejrad.2012.10.030 19. Fernandez Arjona M, Oteros R, Zarca M, Diaz Fernandez J, Cortes I. Percutaneous embolization for erectile dysfunction due to venous leakage: prognostic factors for a good therapeutic result. Eur Urol. (2001) 39:15–9. doi: 10.1159/000052406 20. Bookstein JJ, Lurie AL. Transluminal penile venoablation for impotence: a progress report. Cardiovasc Intervent Radiol. (1988) 11:253–60. doi: 10.1007/BF02577012 21. Kutlu R, Soylu A. Deep dorsal vein embolization with N-butyl-2-cyanoacrylate and lipiodol mixture in venogenic erectile dysfunction: early and late results. Radiol Oncol. (2009) 43:17–25. doi: 10.2478/v10019-009-0011-2 22. Yasumoto R, Nishisaka N, Sakakura T, Kawano M, Shindow K, Takashima S, et al. Ethanol embolization for impotent patients with venous leakage: a new technique and initial results. Minim Invasive Ther Allied Technol. (1996) 5:564–6. doi: 10.3109/13645709609152705 23. Schild HH, Müller SC, Mildenberger P, Strunk H, Kaltenborn H, Kersjes W, et al. Percutaneous penile venoablation for treatment of impotence. CardioVasc Interv Radiol. (1993) 16:280–6. doi: 10.1007/BF02629158 24. Bacon CG, Mittleman MA, Kawachi I, Giovannucci E, Glasser DB, Rimm EB. A prospective study of risk factors for erectile dysfunction. J Urol. (2006) 176:217–21. doi: 10.1016/S0022-5347(06)00589-1 25. Dean RC, Lue TF. Physiology of penile erection and pathophysiology of erectile dysfunction. Urol Clin North Am. (2005) 32:379–95. doi: 10.1016/j.ucl.2005.08.007 .

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The role of the endothelium in erectile function became clearer with the observation that the phosphodiesterase type 5 (PDE5) inhibitor, sildenafil, enhanced erectile function. Erection occurs with the release of nitric oxide (NO) from the vascular endothelial cells.17 The reduction in endothelial cell production of NO results in the negative impact on the smooth muscles in the corporal bodies and results in less relaxation of the smooth muscle cells with decrease in blood supply and resulting ED. A similar phenomenon is well known to impact the coronary arterial system resulting in CVD.
Erections that are too soft for sex.Erections that are don’t last long enough for sex.An inability to get an erection.

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Your doctor will check your penis and testicles to make sure they look normal and their nerves work as expected. They may also look for hair loss and larger-than-normal breasts. Both of these can be signs that you have a hormone problem.
Urology, Male Infertility & Reproductive Health, Reconstructive Urologic Surgery & Trauma

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Burnett AL, Nehra A, Breau RH, et al. Erectile dysfunction: AUA guideline. J Urol. 2018;200(3):633-641. PMID: 29746858 pubmed.ncbi.nlm.nih.gov/29746858. Version Info

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An erection occurs when blood flows into the corpora cavernosa (erection bodies) and gets trapped there. If the blood has problems getting to or staying in those erection bodies, you may have erectile dysfunction.

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    Pelvic floor muscles can be identified by attempting to stop the flow of urine mid-stream. These are the muscles that will be used. Start with an empty bladder and tighten the pelvic floor muscles for 5 seconds, then relax for 5 seconds. Attempt to do 5 repetitions (reps) the first day. Work up to 10 seconds at a time. Aim for 3 sets of 10 reps daily. Avoid tightening muscles in the abdomen, thighs, or buttocks and avoid holding your breath. QUESTION Testosterone is a chemical found only in men. See Answer Men's Health Resources When Prostate Cancer Spreads12 Devices That Can Help Your Low Vision https://bjui-journals.onlinelibrary.wiley.com/doi/pdf/10.1111/j.1464-410X.2005.05690.x https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3275865/

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    Diuretics (pills that increase urine flow)High blood pressure medsAntihistaminesAntidepressantsParkinson's disease drugsAntiarrhythmics (drugs for irregular heartbeat)Tranquilizers and sedativesMuscle relaxantsNonsteroidal anti-inflammatory drugs (NSAIDs)Histamine H2-receptor antagonistsHormonesChemotherapy medicationsProstate cancer drugsAnti-seizure medications

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    The same concerns regarding the use of sildenafil with nitrates and alpha-blockers apply to vardenafil.

    Aetna considers the external penile vacuum pump device medically necessary durable medical equipment (DME) when it is prescribed by a physician as an alternative to other therapies for erectile dysfunction. External penile pumps are considered experimental and investigational for other indications including for the prevention of erectile dysfunction following prostatectomy because their effectiveness for these indications has not been established.
    Self-administered injections of prostaglandin E1 (Caverject® or Invicorp®) provide a simple means of obtaining a natural erection. You will be taught how to administer the injections (pictured) and told what to do in the event of problems such as an erection which will not go down.

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    While popularized in the media, Viagra is not the only erectile dysfunction drug. Other erectile dysfunction drugs include:

    The association of CVD and ED was noted in 1997 as one analysed the results of the MMAS. In this landmark study, 1709 men aged 40–70 years were enrolled between 1987 and 1989. A follow-up some 10 years later revealed a striking relationship between ED and CVD. In this study, it became clear that the risk factors for ED were very similar to those of CVD, such as diabetes mellitus, smoking and dyslipidaemia.18
    When 3724 men were questioned about their dietary habits, men who reported a higher caffeine intake were less likely to report E.D. However, this study was based on self-reported data and was not a prospective study (Lopez et al., 2015). Caffeine is a vasoconstrictor, which means that it can reduce blood flow into the penis. Further study is needed to determine whether caffeine improves or worsens E.D. symptoms.

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    Erectile dysfunction often has more than one cause. Many diseases can cause blood flow problems, damage nerves, arteries and muscles, which can impair erectile function.

    Because ED is often caused by other medical conditions, your doctor will want to know about your medical history.
    Other alternative therapies that may help reduce stress, and in turn, ease ED symptoms, include:

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Sculpted Grecian Body: The Greek Art of Quick Workouts That Build Muscle, Burn Fat And Keep You Injury-Free

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The role of the endothelium in ED has been noted for a number of years and the overlapping of ED and other conditions, especially coronary heart disease, CVD, affecting endothelial function/dysfunction, is clearly present. The endothelial cell is now known to affect vascular tone and impact the process of atherosclerosis, and impacting ED, CVD and peripheral vascular disease.16

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Stability ball is one of the most versatile exercise equipment out there. You can use it to stretch and strengthen any part of your body. Vidyut, for instance, has incorporated it into his kalari sutra workout. He has placed his feet atop it while being in a plank position and pushed his hips upward and downward in an alternate motion, so as to stretch and strengthen the joints. When you do this exercise, make sure you maintain proper balance and stop your legs from falling off the stability ball. Go down on all fours. Place your palms on the floor in line with your shoulders. Lift your legs off the floor and place them on a stability ball. Keep your elbows and knees straight. Raise your hips to make a mountain with your body. Lower your hips and bring them as close to the floor as possible without touching it. Repeat in a seamless motion.

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Currently, there are several different types of penile prostheses. The simplest is the malleable penile prosthesis and the most complex, the three-piece inflatable penile prosthesis.

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