Treatment

Talking about the treatment of erectile dysfunction, I must say that it is advisable to start with the identification and effective management of risk factors, which include some comorbidities, such as diabetes, end-stage chronic renal failure, chronic prostatitis, obesity, hypertension, lower testosterone levels (hypogonadism), etc. Also at step dolechebnom erectile dysfunction patients should be possible to cancel (or replace) the medicines which can impair erection. All of the above activities significantly increase the effectiveness of subsequent treatment .

Therapeutic measures for erectile dysfunction based on the principle of three-stage. Each subsequent stage involves a more aggressive tactics that should be used for the previous inefficiency.

The first stage of treatment is the use of erectile dysfunction drugs tablets from the group of inhibitors of phosphodiesterase -5. Today they are represented by four drugs: Viagra (to buy it, you can go to this site), Cialis, Levitra and Zidenoy. Unlike drugs listed in the rapidity of onset and duration of effect, several different efficiency depending on the severity of erectile dysfunction and incidence of side effects.

The mechanism of action of inhibitors fosofdiesterazy -5 is based on the principle of accumulation of specific substances - cGMP in both the corpora cavernosa of the penis. The latter represent tonkoyacheistuyu muscle structure. Guanosine monophosphate relaxes these muscles, which stimulates cell expansion cavernous tissue and arterial blood filling, then triggered a valve mechanism veins of the penis with the subsequent formation of an erection.

It is also important that the effects of inhibitors of phosphodiesterase -5 is realized only when there is sexual stimulation. In this regard, after their admission before intercourse is necessary to provide "sexual foreplay", which constitute the preliminary actions and endearing game situations.

The overall efficiency of all four phosphodiesterase inhibitors -5 is approximately the same and is celebrated in more than 70 % of patients. These drugs are safe when used correctly, but they should only be administered by a physician. This is due to the fact that there are a number of strict contraindications to joint appointment inhibitors of phosphodiesterase -5 with some drugs of other groups, such as organic nitrates. Incompatible combination medications can be extremely dangerous or even fatal, in patients suffering from diseases of the cardiovascular system.

It should be remembered that patients with severe psychogenic erectile dysfunction as a first-line treatment is expedient to psychosexual therapy. The therapeutic effects should be carried out by medical sexologists, psychiatrists who are involved in diagnosis and treatment of sexual dysfunction.

For alternative methods of therapy in the first stage of erectile dysfunction include the same application of vacuum erector. These devices consist of a plastic flask with attached air pump system. Vacuum Erector placed on the penis, tightly clutching the open end of the bulb to the pubis, and produce pumping air. Formed in this rarefied air environment initiates the sudden influx of blood to the body and creates an erection. To prolong the effect on the base of the penis attached compression ring that prevents venous leak.

At the first stage of treatment failure, local therapy is prescribed for erectile dysfunction. Is the most efficient method of intracavernous injections of prostaglandin E1 pure. Previously applied papaverine and phentolamine are not currently recommended for use, since they are harmful to the tissue of the cavernous bodies of the penis.

There is another method of administration of prostaglandin E1 for Erectile Dysfunction. Using a special applicator mini candle with said preparation is placed in the initial section of the urethra, where absorbed, getting into the corpora cavernosa. At somewhat lower efficiency, this method avoids injections.

Treatment failure first and second lines justifies the use of surgical treatment. When arteriogenic erectile dysfunction exercise intervention aimed at ensuring the flow of blood from additional sources. For this example, inferior epigastric artery was isolated, and moved with the abdominal wall, hemming one of the arteries of the penis. In the case of erectile dysfunction venogennyh perform ligation most important - the deep hinterland vein of the penis, which eliminates the venous leak.

Successful alternative vascular interventions is penile prosthesis. Currently there are a variety of flexible, semi-rigid and fills prostheses are implanted in the cavernous tissue of an organ.

Flexible implants pose a moderate axial hardness of the penis. Because of their flexibility, the wearing of such prostheses does not create any difficulties. However, due to the fact that the penis when installed flexible iplantatah chredzmerno lenient their production is being phased out .

Semirigid prostheses provide a constant hardness of the penis, but it brings some inconvenience, since such a body awkward to move, sit, wear tight-fitting pants and swimming trunks. At the same time, this type of prosthesis has a very affordable price.

Recently, the company AMS ( USA) has developed a new generation of penile implants called Spectra. This model takes an intermediate position between the flexible and semi-rigid prostheses. The structure of this type of implant is similar to the human spinal column, therefore, achieved sufficient hardness and ease of wearing. Installation of high quality falloprotezov Spectra AMS Russian citizens in some government agencies, in particular in the Institute Uronephrology First MGMU behalf IM Sechenov, are free. It should be noted that the program of state guarantees relevant to the end of 2013.

Fills the penis implants are capable of creating high-quality imitation erection. In the inactive state of these prostheses does not manifest itself. The most expensive three- prostheses, even create the majority of patients physiological sensations natural intercourse.

Feature of any penile implants (especially of filled), is their limited resource which depends on the intensity of the sexual life of the patient. On average, the replacement of the original prosthesis by reoperation occurs 1 time in 5-7 years.