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Description: Medically relevant promotional products from Nucleus are just what the doctor ordered. Physicians love to use our URAC approved, scientifically accurate tear sheet pads for patient education and compliance. Perfect for waiting room or exam room displays, with infinitely customizable designs. CALL for pricing information and samples - 800-333-0753.

Product Specifications: 8.5 x 11 inches or 5.5x 8.5 inches; 50 tear sheets, two-sided information (full color front side, one-color back side), printed on white stock, sturdy cardboard back, detailed medical illustrations in color and continuous tone, space available for overprinting of contact information or product may be customized with new artwork or text (additional charge may... More

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Medically relevant promotional products from Nucleus are just what the doctor ordered. Physicians love to use our URAC approved, scientifically accurate tear sheet pads for patient education and compliance. Perfect for waiting room or exam room displays, with infinitely customizable designs. CALL for pricing information and samples - 800-333-0753.

Product Specifications: 8.5 x 11 inches or 5.5x 8.5 inches; 50 tear sheets, two-sided information (full color front side, one-color back side), printed on white stock, sturdy cardboard back, detailed medical illustrations in color and continuous tone, space available for overprinting of contact information or product may be customized with new artwork or text (additional charge may apply).

This tear sheet pad contains the following information:

Impotence

Definition

Impotence is the inability to attain or maintain an erection of the penis that is firm enough for sexual intercourse. Causes

To initiate and maintain an erection, the penis must fill with blood. Nerve signals stimulate this engorgement. They prompt the blood vessels in the penis to expand so blood can fill it. Meanwhile, other blood vessels constrict, trapping blood inside.

The following factors can cause erectile dysfunction: Venous Leak

If a leak in the blood vessels in the penis allows blood to escape, an erection may not be attainable, or may not last long. This can be caused by injury or disease. Neurovascular Function

* Arteriosclerosis (hardening of the arteries) can cause reduced blood flow.
* Diabetes can interfere with nerve signals.
* Erection cannot be attained if nerve signals do not prompt blood vessels to expand or if blood flow to the penis is reduced.
* Many medications also cause erectile dysfunction through this mechanism.
* Nerve dysfunction can also diminish feeling in the penis resulting in impotence.
* Peripheral neuropathy, spinal cord injury, and surgery can also damage nerves.

Psychological Factors

The brain initiates many of the nerve signals required for a successful erection. Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

* Age: 65 and older
* Behaviors:
      o Alcohol use
      o Anabolic steroid use
      o Heavy smoking
      o Illegal drug use
      o Interpersonal conflicts with a sexual partner
* Medical conditions:
      o Arteriosclerosis (hardening of arteries)
      o Chronic kidney disease
      o Diabetes
      o Endocrine disorders
      o Hypertension
      o Liver failure
      o Neurological disorders (i.e., multiple sclerosis, peripheral neuropathy, stroke)
      o Peyronie's disease (bending of the penis caused by scar tissue)
      o Psychiatric disorders (i.e., anxiety, depression)
* Medications:
      o Antidepressants
      o Antihistamines
      o Antihypertensives
      o Antipsychotics
      o Tranquilizers
* Traumatic conditions:
      o Pelvic surgeries (particularly for prostate cancer)
      o Spinal cord injury
      o Vascular surgery

Symptoms

Symptoms include:

* A less firm penis
* Fewer erections

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Expect questions about the frequency, quality, and duration of your erections. Your answers may help determine if primarily psychological or physical factors are causing your impotence.

The doctor will examine your penis, testes, and rectum. If a physical cause is suspected, the doctor may order laboratory tests. Treatment

Treatment options include:

Sildenafil (Viagra) – taken orally up to once a day, 30 to 60 minutes before sexual activity

Alprostadil – either injected into the penis or inserted into the urethra as a suppository

OralTestosterone – only for men whose impotence is caused by low testosterone levels

Vacuum Devices

* Elastic band for holding the erection after removal of the cylinder
* Hand pump for pumping air out of the cylinder
* Plastic cylinder for the penis

Vascular Surgery – repairs venous leaks, and has been shown to be effective in some cases

Penile Implants – semirigid, malleable and inflatable implants that are surgically inserted into the penis

Sex Therapy – may help impotence resulting from:

* Anxiety
* Depression
* Ineffective sexual techniques
* Relationship problems

Prevention

To reduce your chances of becoming impotent:

* If medications may be the problem, ask your doctor about changing the medication or adjusting the regimen.
* Maintain a healthful lifestyle and diet.
* Take medications to manage blood pressure, diabetes, or depression.
* Try ongoing communication and relationship counseling to prevent or manage interpersonal conflict.

Last reviewed: July 2003 by Lawrence Frisch, MD, MPH.

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