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The risk of having ED after prostate cancer treatment depends on the surgical technique or type of radiation used by your doctor, but also on your:

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There is reliable evidence that oral phosphodiesterase-5 (PDE-5) inhibitors (e.g., sildenafil, vardenafil, tadalafil, mirodenafil, and udenafil) improve erectile functioning in men with ED. However, there is a lack of reliable evidence of the efficacy of hormonal treatments and the value of hormone testing for ED. The American College of Physicians (ACP) developed guidelines on hormonal testing and pharmacological treatments of ED (Qaseem et al, 2009). Current drug therapies include PDE-5 inhibitors as well as hormonal treatment. The ACP recommended clinicians initiate therapy with a PDE-5 inhibitor in men who seek treatment for erectile dysfunction and who do not have a contra-indication to PDE-5 inhibitor use, and clinicians base the choice of a specific PDE-5 inhibitor on the individual preferences of men with erectile dysfunction, including ease of use, cost of medication, and adverse effects profile.
The recommended starting dose is 100 mg taken as early as 15 minutes prior to sexual activity, no more than once a day. The maximum dose is 200 mg. Avanafil may be taken with or without food. As with the other PDE5 inhibitors, sexual stimulation is necessary for avanafil to work. .

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Erythrocytosis has been noted in men on TRT, and should be monitored every 6–12 months depending upon the patients’ response to changes in haematocrit levels. For mild elevations, the dosage of testosterone can be decreased or the interval of using the medication can be increased. With the haematocrit greater than 50%, decisions to temporarily discontinue the medication or periodic phlebotomy may be indicated.38
A man could try new activities, like swimming. Yard work and gardening count as physical activity. A man’s goal should be to be physically active for 30 minutes a day, at least four days a week.

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Men with ED without hypogonadism (a low testosterone level and symptoms related to this) should not use testosterone therapy.
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Alprostadil is an FDA-approved erectile dysfunction drug that can be injected directly into the penis to trigger an automatic erection. "Penile injection is the most effective type of ED treatment for men who can't take oral treatment," says Nelson Bennett, MD, a urologist at the Lahey Clinic in Burlington, Mass. In fact, it has an 85 percent success rate. Possible side effects include a burning sensation and priapism, an erection that lasts more than four hours and requires medical treatment.

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Furthermore, an UpToDate review on “Treatment of male sexual dysfunction” (Cunningham and Seftel, 2014) does not mention nicardipine and statins as therapeutic options.

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    Oral drugs such as Viagra, Cialis, Levitra, or StendraTestosterone therapyPenis injectionsVacuum erection pumpsIntraurethral medicationPenile implants such as semi-rigid implants or inflatable implantsSurgery to repair artery damage after trauma to the penis

    Low intensity shockwave therapy(LiST) is a groundbreaking “drug and surgery-free” procedure that uses acoustic waves to stimulate a cascade of biological actions that lead to the healing and regeneration of the sexual organs. Simply…LiST helps your body heal itself! Learn more about Low Intensity Shockwave Therapy. Oral medications for ED are called PDE-5 inhibitors. The drugs in this class include medications like Viagra, Levitra, Cialis, Stendra and more. This class of drugs is considered first line therapy for those men presenting with ED. Learn More About Oral Medications for ED. Penile injection therapy involves an injection of a medication into the shaft of the penis on an as needed basis to produce a rapid erection. It is commonly used by patients who have failed oral medications. Learn more about this very effective treatment. The same medicine used for penile injection may be used as a very small suppository placed into the tip of the penis to provoke an erection.
    With so many possible causes for ED, your doctor has a number of tests they can use to figure out the best treatment for you.

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    Not only this but under the guidance of the best sexologist in India and a team of the best sexual health experts, we offer Special Relationship Counselling Sessions and Couple Therapies to treat all the psychological causes of ED.

    If these medications fail to work or if you are deemed unfit to take them, your urologist can recommend one or more of the following therapies: Penile pump (vacuum erection device [VED] or vacuum constriction device [VCD]) Penile injections (intracavernous injection [ICI], intracavernosal alprostadil) Intraurethral (IU) medication (alprostadil) Surgical procedure involving fitting a penile implant into the penis
    Patients should continue testosterone therapy only if there is improvement in the symptoms of hypogonadism and should be monitored regularly. You will need periodic blood tests for testosterone levels and blood tests to monitor your blood count and PSA. Testosterone therapy has health risks, and thus doctors should closely monitor its use. Testosterone therapy can worsen sleep apnea and congestive heart failure.

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    Our staff is available to assist you in scheduling an appointment with one of our specialists.

    Click here to use our feedback form & send us your comments about this section of the BAUS website; this will help us to improve it for the benefit of our patients
    Men can have several types of issues including poor sex drive and problems with ejaculation. But ED refers specifically to trouble getting or keeping an erection. You might have a healthy sex drive, but a body that won’t respond. Most of the time there is a physical basis for the problem.

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    Because of changes in regulations, you no longer need a prescription to get sildenafil.

    Prostate, bladder, colon, and rectal cancer are sometimes treated with radiation to the pelvis. This can cause problems with erections. The higher the total dose of radiation and the wider the section of the pelvis treated, the greater the chance of erection problems later. If radiation therapy is part of your treatment plan, talk to your doctor before it starts. Ask how your arteries and nerves might be affected by radiation therapy so you know what to expect.
    Diabetes mellitus, smoking, high cholesterol, and high blood pressure are all risk factors for oxidative stress. These conditions are some of the most common causes of E.D. (Zhang et al., 2011). Antioxidants decrease metabolic stress and reduce the risk of blood vessel damage.

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Erosion of the prosthesis, whereby it presses through the corporal tissue into the urethra, may occur. Symptoms and signs may include pain, blood in the urine, discharge, abnormal urine stream, and malfunction. If the prosthesis erodes into the urethra, a physician must remove it. If the other cylinder remains intact, it can be left in place. A physician leaves a catheter in place to allow the urethra to heal.

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Urology, Male Infertility & Reproductive Health, Reconstructive Urologic Surgery & Trauma

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Low testosterone (low-T) can be caused by conditions such as type 2 diabetes, obesity, liver or kidney disease, hormonal disorders, certain infections, and hypogonadism. Signs and symptoms that a person may have low-T include insomnia, increased body fat, weight gain, reduced muscle, infertility, decreased sex drive, depression, and worsening of congestive heart failure or sleep apnea. Low-T can be treated with testosterone therapy in the form of gels, injections, pellets, or skin patches. Side effects of testosterone treatment include acne, anxiety, hair loss, headache, and change in sex drive (libido).

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