Hekal et al 23 evaluated penile vascular changes in patients undergoing nerve-sparing and non-nerve-

In addition, radiation therapy is often part of the regimen used to prepare a patient for bone marrow transplant (eg, treatment of leukemias and lymphomas). Brachytherapy has a higher rate of preservation of erectile function than EBRT: 68% compared with 58% for EBRT. Kimura et al 14 found decreased cyclic guanosine monophosphate levels (important in mediating erections) in the radiated group (25 Gy) compared with controls.

Several animal model studies have examined stereotactic body radiation therapy to the prostate, neurovascular bundles, and penile bulb. The mean follow-up time since treatment was 47.3 ± 26.8 months, at which point 20.8% of patients reported ED. 9. Chemotherapy agents such as cisplatin or vincristine may interfere with the nerves and vasculature that control erection.

Sexual dysfunction should be anticipated and couples counseled before ADT is started. Androgen-deprivation therapy (ADT) is commonly used in the treatment of prostate cancer. The ability to achieve and maintain an erection depends on the penile innervation as well as the peripheral nerves, the integrity of the vascular supply, and biochemical signaling within the corpora.

During return to flaccid state, muscle contractions result in increased venous outflow, decreasing penile length and girth. Penile erection is achieved through five phases: initial filling, partial erection, full erection, rigid erection, and return to flaccid state. ED is the inability to obtain or maintain an erection firm enough for sexual intercourse; this differs from infertility, which is the inability to conceive a child.

Additional factors that play a role include patient age and degree of ED before starting cancer treatment. A primary care doctor can give a preliminary diagnosis of ED based on a patient history and a physical examination, but may refer a patient to a speFildenat, such as a urologist. Various treatment options are available and you should discuss them with your doctor.

Certain types of surgery and radiation therapy. Myth: Erectile Dysfunction is complex to diagnose and treat. Age-related conditions and medications used to treat various medical conditions increase the likelihood that ED will occur.

Myth: Erectile Dysfunction is a condition affecting only elderly men. Myth: The majority of cases of Erectile Dysfunction are psychologically caused. Fact: A large health survey in the U.S.A. found 52% of men aged 40 to 70 years had some degree of difficulty achieving and/or maintaining an erection.

The failure of sufferers to seek treatment is especially unfortunate because ED is a treatable condition and may be a symptom of another underlying medical problem that needs to be treated as well. "Mayo," "Mayo Clinic," "," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.
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