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Information on Erection Problems & Erectile Dysfunction
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Surgery, erection problems and erectile dysfunctionA number of surgical procedures can lead to erection problems, chief among them being prostatectomy. Up until the mid-1980s, reports of erectile problems after prostate surgery suggested that up to 85% of men had erection problems. At this point, Walch et. al. devised a new surgical technique for prostate surgery which was designed to avoid the nerve damage that can occur during conventional surgery. The patients who have this surgery need to be very carefully chosen, in which case the occurrence of erectile problems after surgery is reduced to about 15%. Unfortunately the technique can only be used in men who have an isolated lesion which appears on only one side of the prostate gland. Sadly, prostate cancer usually occurs on both sides of the prostate. This means that only a limited number of men are candidates for this type of surgery. And that in turn means the incidence of erection problems and erectile dysfunction among men who have prostate surgery ranges from 15 percent among men who have the nerve-sparing procedure up to 60 to 85 percent of men who have conventional surgery (which is most men). As many older men will know, the most common operation performed on the male urinary system is transurethral resection of the prostate (TURP) for removal of prostate tissue which has grown into the urethra. Over the years, the incidence of erectile dysfunction following this procedure has been estimated at between 0 and 13%. Drug related erectile dysfunctionA large number of therapeutic drugs may have an undesired side effect of erectile dysfunction. Why this happens is mostly unknown, but cessation of the drug regime tends to bring about an improvement or complete reversal. The impact on the erectile mechanism of certain drugs, however, is not reversible. Some drugs used to suppress tremor in Parkinsons's patients, such as benztropine (Cogentin) and trihexyphenidyl (Artane), do so by blocking acetycholine in the brain. When they block acetylcholine, the key initiator of nitric oxide release from the endothelial cells of the erectile tissue in the autonomic nervous system, then erectile dysfunction is the inevitable result. Other drugs used by Parkinson's patients that frequently cause or aggravate erectile dysfunction include the anti-cholinergic drugs, the tricyclic anti-depressants with anticholinergic activity, antihistamines, alcohol, and beta-blockers. Pelvic trauma and erectile dysfunctionAs you might expect, any kind of forceful trauma in the pelvic region can damage the nerves and surrounding tissues of the urethra, the penis and therefore by implication the erectile tissue, nerves and blood vessels. Even after surgical repair, many men who have suffered this kind of injury find they have a problem with erectile dysfunction from all of the damage to the nerve and blood supplies to the penis. Pelvic radiation Up to 10 percent of men for whom this option is used to treat prostate cancer will develop erectile dysfunction as a side effect. And in fact some studies have shown that the rate of erectile dysfunction is much worse: one such study showed that fifteen out of sixteen patients treated with external beam radiation therapy complained afterwards of some degree of erection difficulty. But it's possible that some research failed to look at how much erectile dysfunction was present preoperatively and therefore have over-estimated the effect on a man's erection of such treatment on the prostate. It's now an established fact that between 20 and 30 percent of patients receiving therapy for prostate cancer have "significant" erection problems before the radiation therapy. Drugs that May Produce Erectile DysfunctionAntihypertensives (for treatment of high blood
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