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In a setting of a previous pelvic trauma, X-rays may be performed to assess various bony abnormalities. Ultrasound of the penis and testicles is done occasionally to check for testicular size and structural abnormalities. Ultrasound with Doppler imaging can provide additional information about blood flow of the penis. Rarely, an angiogram may be performed in cases in which possible vascular surgery could be beneficial. Quitting smoking, exercising regularly, losing excess weight, curtailing excessive alcohol consumption, controlling hypertension, and optimizing blood glucose levels in patients with diabetes are not only important for maintaining good health but also may improve or even prevent erectile function. Some studies suggest that men who have made lifestyle improvements experience increased rates of success with oral medications. What Is Erectile Dysfunction? Also known as impotence, erectile dysfunction is defined as the inability to attain and/or maintain an erection suitable for intercourse. Causes of erectile dysfunction include diseases affecting blood flow, such as atherosclerosis (hardening of the arteries); nerve disorders; psychological factors, such as stress, depression, and performance anxiety (nervousness over his ability to sexually perform); and injury to the penis. Chronic illness, certain drugs, and a condition called Peyronie's disease (scar tissue in the penis) also can cause erectile dysfunction. buy propecia online propecia online
What are intracavernosal injections? Medications can be injected directly into the corpora cavernosa to attain and maintain erections. Medications such as papaverine hydrochloride, phentolamine, and prostaglandin E1 (alprostadil) can be used alone or in combinations to attain erections. Combining small amounts of each drug is preferred over using a single drug because of increased efficacy and fewer side effects. Even though such injections can be effective in the management of erectile dysfunction (success rate of around 80%), they are not widely used because of their potential complications. These injections are painful, can cause scarring of the penis, and have a higher risk of developing priapism. buy propecia best price buy propecia best price viagra find online pages edinburgh free viagra online
How does an erection normally occur? When you are sexually aroused, messages from your brain travel down nerves to your penis. Chemicals called neurotransmitters are then released from the ends of the nerves in the penis. Stimulation of the penis can also cause local nerve endings to release neurotransmitter chemicals. Erectile dysfunction, heart disease and other vascular diseases: The root cause of the narrowing of the arteries is caused by atheroma. Atheroma is like fatty patches or plaques that develop within the inside lining of arteries. (This is similar to water pipes that get furred up with scale.) Plaques of atheroma may gradually form over a number of years in one or more places in the body, commonly in arteries going to the heart, brain, legs and penis. In time, these can become bigger and cause enough narrowing of one or more of the arteries to cause symptoms and problems. Who should not use tadalafil (Cialis)? Tadalafil can cause hypotension (abnormally low blood pressure, which can lead to fainting and even shock) when given to patients who are taking nitrates. Patients taking nitrates daily should not take tadalafil. Most commonly used nitrates are medications to relieve angina (chest pain due to insufficient blood supply to heart muscle because of narrowing of the coronary arteries). These include nitroglycerine tablets, patches, ointments, sprays, pastes, and isosorbide dinitrate and isosorbide mononitrate. Other nitrates such as amyl nitrate and butyl nitrate are found in some recreational drugs called "poppers."