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This was both diagnostic and clinically important
Other endocrine, or hormonal, causes are far less common, accounting for only about 4 percent of all cases of male erectile dysfunction. Diabetes is the number one single cause of male erectile dys function, accounting for about 40 percent of all impotence cases.' These more invasive studies are generally reserved for those very rare patients who will require vascular surgery or consideration of vascular surgery. For those very few patients who have a primary vascular problem that is surgically correctable, there are more complicated tests available, including Duplex ultrasound studies and dynamic infusion cavernosography and cavernosometry (DICC). The latter two techniques are reserved for those patients who have a high likelihood of having a psychological problem, or those in whom some type of financial settlement or litigation depends on an accurate assessment of the cause of their erectile dysfunction. This test can be performed by several methods, including a simple snap-gauge test, the Rigiscan device, or a more formal sleep laboratory. In those patients whose erectile dysfunction is not solved by Viagra, nocturnal penile tumescence (NPT) testing may further help differentiate psychological dysfunction from physical dysfunction.
Even when Viagra is not successful, most urologists will have the patient evaluated, and on a treatment protocol within two additional office visits. After a four- to six-week trial with Viagra, if the patient is not having a successful response, we continue the assessment with the "Pre-Viagra" protocol. Today, with the availability of Viagra, the first step after the history and physical exam is to start the patient on Viagra. Patients who did not respond were felt to have a significant compromise to the vascular supply to the erectile tissue and, in all likelihood, would probably require a penile implant, with or without any additional extensive vascular testing. Patients who did respond to one of several vasoactive injections in the office had the option of using this protocol at home.
To make the postage stamp test more accurate | Three additional tests are available | Knowing the history of problems with libido | Examination of the penis may yield a finding | This was both diagnostic and clinically | Diabetes mellitus is a disease of | Again, the importance of a very thorough history | Sometimes, the return to a normal testosterone | At present, there are oral medications | Soon after the surgery he fathered a child | Mr. W was 23 years old and complained | This form of testosterone replacement | Testosterone therapy is contraindicated | This kind of erection problem only requires | This results in their losing control | The experience in the mid-1980s was | Your ability to perform sexually is not a | The primary advantages of papaverine | One recent study reported systemic papaverine | PDE5 - an enzyme found in the penis | This translates into a cost increase combination | Depending on the dose required, the patient | Each of these agents has its advantages | The injection protocol has returned | The prescription refill rate for MUSE has | Even more rare is the patient who | There is no current way to evaluate, diagnose | In nature, these bones begin as a pair | It just gets too crowded to do cystoscopic | The pump, controlled by external squeezing | The three-piece American Medical | If the patient has Medicare or Blue
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