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Most commonly reported adverse effect is headache, which occurred in 15% of men taking the 20-mg dose, 11% of those taking 10 mg, and 11% of those taking 5 mg; this compares with 5% of those who took placebo; dyspepsia is second most common adverse effect and is observed in 10% of men taking 20 mg, 8% taking 10 mg, and 4% taking 5 mg; dyspepsia occurred in only 1% of controls
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Penile erection is managed by two different mechanisms. The first one is the reflex erection, which is achieved by directly touching the penile shaft. The second is the psychogenic erection, which is achieved by erotic or emotional stimuli. The former uses the peripheral nerves and the lower parts of the spinal cord, whereas the latter uses the limbic system of the brain. In both conditions, an intact neural system is required for a successful and complete erection. Stimulation of penile shaft by the nervous system leads to the secretion of nitric oxide (NO), which causes the relaxation of smooth muscles of corpora cavernosa (the main erectile tissue of penis), and subsequently penile erection. Additionally, adequate levels of testosterone (produced by the testes) and an intact pituitary gland are required for the development of a healthy erectile system. As can be understood from the mechanisms of a normal erection, impotence may develop due to hormonal deficiency, disorders of the neural system, lack of adequate penile blood supply or psychological problems. Restriction of blood flow can arise from impaired endothelial function due to the usual causes associated with coronary artery disease, but can also be caused by prolonged exposure to bright light.
To get the most benefit, you should exercise at least 20 to 30 minutes, preferably on most days of the week. Current studies suggest that at least five times a week is best. If you are a beginner, exercise for a few minutes each day and build up to 30 minutes.
Radiation treatment can cause both bladder and bowel incontinence. It can also lead to impotence, although that effect does not take place immediately.
Alprostadil, a synthetic PGE1, is the most common single agent used for intracavernosal injections. When combined with papaverine and Regitine, the mixture is called Trimix and it has roughly twice the efficacy of alprostadil alone. In one study of 683 men, 94% reported having erections suitable for penetration after alprostadil injections. The main adverse effects are a painful erection, priapism, or the development of scarring at the site of the injection. Alprostadil is now available in a gel and a patch. No long-term studies compare the efficacy and acceptance of these new forms of therapy with that of the oral agents.
Documented hypersensitivity; concurrent or intermittent use of alpha-blockers (eg, doxazosin, terazosin, prazosin), with the exception of tamsulosin (Flomax) 0.4 mg/d
As for the current study, Vorona said it makes sense that the two conditions might be linked "on a physiological basis," perhaps through dopamine.
Ease of administration makes oral medication advantageous. Some drugs, however, are suitable for only a relatively small group of men, and in many cases, oral medications may by less effective than other treatments.
"The key to curing more prostate cancer is to give higher does of radiation," observed Horwitz. "And over the last few years, more and more men have been getting higher dose radiation, because the radiation oncology community knows that dose matters and that low dose radiation is just not effective compared to high dose. And this study shows that we have the ability to give these high doses in different ways, and in all these ways, men do very well."
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