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Suggest Remedies For Erectile Dysfunction

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Posted on Tue, 21 Jun 2016
Question: i suffer from ed. i had been taking viagra regularly and had--until March--no difficulty in getting results. Suddenly viagra ceased to work. My PCP prescribed cialis, and it worked for two weeks. He then gave me a prescription for levitra. Same thing. After that, he referred my to a urologist. The urologist whom I saw Thursday put me back on cialis, and said my problem was not waiting long enough. An hour minimum. Well and good. I tried that today. Nothing. In the meantime, I--on my own--had decided to increase intervals between masturbation. I have done nothing since Friday. I have had no ejaculations now for two weeks now. The urologist told me to return to him in a month. I can't believe he expected me to go that long. My thought is to next try levitra, wait a week, and if nothing happens, contact the urologist. What do you think? (The urologist is aware of all the medications I take, ambien, ativan (occasionally) and said they posed no problem. I even cut down on them). This thing is really getting to me
doctor
Answered by Dr. Dr. P. T. Patil (3 hours later)
Brief Answer:
Your problem of ED needs to be investigated .

Detailed Answer:
Hello
Thanks for your query ,based on the facts that you have posted it appears that you have are facing problem of Erectile Dysfunction and was taking Sildenafil (Viagra) and Cialis however you are not getting Erection hard enough to perform sex .

I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Are you diabetic?
2) Do you have hypertension (High B.P).

Since you are not getting erection even after taking maximum recomonded dose of either Viagra or Cialis The cause of Ed after the age of 60 years is due to following common factors
1) Atherosclerosis of Penile arteries as a process generalized atherosclerosis at this age resulting into reduced blood supply to erectile tissue in penis
2) Senile changes in arterioles (vasculitis) associated with atherosclerosis .

Consult qualified Urologist for clinical assessment and get Color Doppler Ultrasound Scan of the Penis done to trace out the Vasculogenic cause for our ED which could be either arterial insufficiency or Venous leak .

Further treatment will depend upon result of this test and final diagnosis.

Hope I have answered your query, please feel free to ask if you have more questions, I shall be happy to help you .
Thanks and Regards.
Dr.Patil.




Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Dr. P. T. Patil (19 hours later)
Thanks for that reply; it was quite helpful
I am not a diabetic and my blood pressure is normal. Do you think the idea of increasing intervals between masturbation is a bad idea? The longer the interval, the more likely a salutary result. At least that sounds plausible to me As for the idea of waiting a month for a follow-up, I think, given what's happened, that is too long.
I should add that the urologist found my cholesterol to be "a little high" and prescribed Lipitor. They say depression can cause ed but in my case anyway, it's more likely the reverse. What do you think of pumps and--the word shivers down my spine--injections.
doctor
Answered by Dr. Dr. P. T. Patil (13 minutes later)
Brief Answer:
You can use Vacum pump

Detailed Answer:
Hello
Thanks for follow up .

Increasing interval between masturbation will not resolve the basic cause of your ED .
At the outset you have to establish the cause for reduced blood flow to erectile tissue which can be confirmed only with the test I have suggested .

You can use vacuum pump which is mechanical device and helps to sustain erection by preventing blood from penis by blocking return of blood with compression .However it is very cumbersome device and can not be used frequently as there is every risk of getting injury to penis .

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (23 minutes later)
I realize that. On the other hand (no pun), doing so every day has psychological consequences--tingling sensation in the penis, among other things--that can be very frustrating. I will ask the urologist to perform the tests you suggested. I should not attempt to masturbate out of a sense of duty. Do you agree?
doctor
Answered by Dr. Dr. P. T. Patil (1 hour later)
Brief Answer:
Go ahead and get the tests done .

Detailed Answer:
Hello
Thanks for follow up.

go ahead and get the test done .Do write about the result of the test .I shall be happy to help you .
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (16 hours later)
Quick question--does the test take place in the doctor's office?

My next appointment is not for a month, but I think--given the abject failure of the strategy he recommended (wait an a hour and you should be OK), I should contact him earlier. That my decision of course and I realize that, but I wonder if you would
be kind enough to comment.

Thanks again. This dialogure has been most helpful.
doctor
Answered by Dr. Dr. P. T. Patil (5 hours later)
Brief Answer:
This test is done by Radiologist (Sonologist)

Detailed Answer:
Hello
Thanks for follow up

This test is done by Radiologist (Sonologist) .

Normally it takes one hour to achieve hard erection after taking Viagra or Cialis .Hence your PCP might have advised you to wait for one hour .
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (48 hours later)
I have an appointment with the urologist on Monday 16 May. I will discuss the Doppler Ultra Sound Scan, but this may not be possible immediately. I leave for Berlin on 25 May and won't be back till the end of XXXXXXX

Have you heard of Coverlet Release-impulse? A needle. Is that dangerous,

I may add that I tried again today with Levitra. Nothing. This came on so suddenly.
doctor
Answered by Dr. Dr. P. T. Patil (1 hour later)
Brief Answer:
You can get this test done in Germany .

Detailed Answer:
Hello
Thanks for follow up.

I have not heard of Coverlet Release Impulse .

Thanks and Regards.
Dr XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (1 hour later)
Caverject Impulse is the brand name of a medicine that is frequently prescribed in Canada for treating erectile dysfunction in men. Erectile dysfunction is fairly common and though there are no accurate statistics on the number of males suffering from this condition, doctors are certain that almost fifty percent of men aged between forty years and seventy years suffer from some form of this disorder. In order to combat this condition and instil confidence in men, doctors often prescribe Caverject Impulse as a viable treatment option. The chief ingredient in Caverject Impulse is alprostadil, available as the naturally occurring variation of prostaglandin. The medication is distributed by Pharmacia & Upjohn, a division of Pfizer Inc and is available in two strengths of 10mcg and 20mcg. Since the medicine is to be injected on to the patient’s penis, it is presented as a comprehensive package comprising a single-dose, dual chamber, disposable syringe structure. The front chamber contains a glass cartridge containing sterile and freeze-dried alprostadil and while the rear chamber contains sterile water. The actual solution to be injected is reconstituted using the sterile water and the dry medicine provided. After reconstitution, the volume of the medicine becomes 0.64ml of which 0.5ml is delivered inside the penis. Depending on the strength of Caverject Impulse used, the injected solution provides either 10mcg or 20mcg of alprostadil in your penile area. Once injected, the medicine produces an erection in about five to twenty minutes and the erection lasts for about thirty minutes to an hour.
doctor
Answered by Dr. Dr. P. T. Patil (4 hours later)
Brief Answer:
You have mentioned Coverlet Release Impulse and not Caverjet.

Detailed Answer:
Hello Thanks for follow up .

I could not make any comment as you have mentioned Coverlet Release Impulse .

I routinely prescribe intracavernosal Caverjet injection to my patients of ED who do not respond to Viagra or Cialis after they have been proved the cause of Ed being vasculogenic in origin by doing Penile Doppler Scan .

Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (2 days later)
Just wanted to let you know that I had a major ejaculation today, the first time in three weeks with the help of Viagra, the medication that worked so well for so long.

Does this change your (electronic) diagnosis?

doctor
Answered by Dr. Dr. P. T. Patil (2 hours later)
Brief Answer:
Erection and Ejaculation are two different entities

Detailed Answer:
Hello
Thanks for follow up .

Erection and Ejaculation are two different processes .Erection is process where Erectile tissue is filled with large volume of blood to make it hard to have penetrative Intra Vaginal sex where as Ejaculation is expulsion of semen which is end result (Climax ) of sexual stimulation during intercourse or masturbation .

One can ejaculate even without getting erection ,

Viagra helps to achieve Erection and has no effect on ejaculation .

The large volume of ejaculate that you had after 3 weeks may be due to stagnant semen collected and stored in seminal vesicles over a period of long time

Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (4 minutes later)
Then go ahead with the PDS? (see above).
doctor
Answered by Dr. Dr. P. T. Patil (5 minutes later)
Brief Answer:
O.K .Get the test done if you desire so .

Detailed Answer:
Thanks for suggestion and follow up .
I have suggested the test which I routinely carry out for my elderly patients with ED .
You can get it done if you desire so to find out the cause for ED.
Thanks and Regards.
Dr.Patil.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 10586 Questions

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Suggest Remedies For Erectile Dysfunction

Brief Answer: Your problem of ED needs to be investigated . Detailed Answer: Hello Thanks for your query ,based on the facts that you have posted it appears that you have are facing problem of Erectile Dysfunction and was taking Sildenafil (Viagra) and Cialis however you are not getting Erection hard enough to perform sex . I shall be happy if you can post me few more details to help me in making comments on your problem. 1) Are you diabetic? 2) Do you have hypertension (High B.P). Since you are not getting erection even after taking maximum recomonded dose of either Viagra or Cialis The cause of Ed after the age of 60 years is due to following common factors 1) Atherosclerosis of Penile arteries as a process generalized atherosclerosis at this age resulting into reduced blood supply to erectile tissue in penis 2) Senile changes in arterioles (vasculitis) associated with atherosclerosis . Consult qualified Urologist for clinical assessment and get Color Doppler Ultrasound Scan of the Penis done to trace out the Vasculogenic cause for our ED which could be either arterial insufficiency or Venous leak . Further treatment will depend upon result of this test and final diagnosis. Hope I have answered your query, please feel free to ask if you have more questions, I shall be happy to help you . Thanks and Regards. Dr.Patil.