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admin | Category: Ed Treatment San Antonio | 21.07.2015
This is a  disorder of the persistent inability to attain or maintain penile erection sufficient for sexual intercourse,affects millions of men to various degrees. The penis consists of two parallel cylinders of erectile tissue, the corpora cavernosa (which has a mesh work of vascular endothelium), and a smaller,single ventrally placed cylinder,the corpus spongiosum, which surrounds the urethra and distally forms the glans penis.Venous drainage of the erectile bodies occurs via postcavernous venules draining into the deep dorsal vein. In the flaccid penis, a balance exists between blood flow in and out of the erectile bodies. In addition to diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, and vascular disease account for about 70 percent of all cases of ED.
As mental tension leads to adrenaline production, the tissues are getting constricted preventing the erection. Medication: ED is also a side effect of many common drugs, including prescription and over-the-counter medications and illegal drugs. But Alcohol is a depressant, and, when consumed in more than small amounts, it really reduces the ability to have an erection. Nicotine directly interferes with the nerve pathways that produce and maintain an erection, and tobacco smoke causes heart disease and circulatory problems that reduce the supply of blood to the penis and destroy the flexibility of tissues. Due to sedentary  life style and increased intake of fatty food leads to blocking of arteries with fat deposits. The one of the common misconception is that ED is a part of aging and has to be accepted as such.
Impotence can be more than a sexual health disorder and signals a number of other health problems, including heart disease.
A recent study published in journal Circulation found erectile dysfunction as a warning sign for several health issues, especially heart disease. The relation between impotence and other health problems lies with the blockage of arteries. Since the penile arteries are smaller, these are the first to be affected, thus providing a warning sign of potential health problems. The effect of plaque buildup depends on the organs and tissues nourished by the plaque-affected arteries and blood vessels.
A few lifestyle changes could go a long way in helping you protect an erection and prevent ED as well as other health disorders, which have common risk factors as erectile dysfunction. The key structures mediating penile erection are the paired corpora cavernosa or 'erectile bodies' (Figure 1). Each corpus cavernosum has a thick fibrous sheath, the so-called tunica albuginea, which surrounds the erectile tissue, made up of multiple lacunar spaces that are inter-connected and lined by vascular endothelium (Figure 2). The corpus spongiosum surrounds the urethra, which traverses the length of the penis within this structure, lying in the ventral groove formed by the paired corpora cavernosa in the pendulous portion. The corpus spongiosum in the bulbar region is surrounded by the bulbospongiosus muscles (Figure 4).
The skin overlying the penis is exceptionally mobile and expandable to accommodate the considerable increase in girth and length that occurs during erection. The pendulous portion of the penis is supported and stabilized by the suspensory ligament (Figure 6).
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Inability to constantly control the ejaculatory reflex is a common sexual disorder affecting all age groups ..
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The blood supply to each corpus cavernosum is derived mainly from the internal iliac artery, a branch of the atheroma-prone common iliac artery. Lymph is drained from the penis by lymphatics which pass to the superficial and deep inguinal lymph nodes of the femoral triangle (Figure 12). Three sets of peripheral nerves are involved in penile erection and subsequent detumescence: parasympathetic nerves from the second to fourth sacral (S2-S4) segments, sympathetic nerves from the tenth thoracic to the second lumbar (T10-L2) thoracolumbar outflow, and somatic fibers via the pudendal nerves (Figure 14). The sympathetic nerves reach the corpora, as well as the prostate and bladder neck, via the hypogastric nerves, where they are susceptible to injury in retroperitoneal lymph node dissection performed for the treatment of metastatic testicular cancer. Postganglionic noradrenergic fibers pass posterolateral to the prostate in the so-called nerves of Walsh to enter the corpora cavernosa medially. Parasympathetic nerves stem from the so-called sacral erection center and their cell bodies lie in the intermediolateral nuclei from S2 to S4. The pudendal nerves comprise motor efferent and sensory afferent fibers which innervate the ischiocavernosus and bulbocavernosus muscles as well as the penile and perineal skin. Although reflex spinal erections may occur provided that the sacral reflexes are intact (for example, after cervical or thoracic spinal injury), central connections are paramount in engendering the normal male sexual response.
A number of areas in the brain are involved in the modulation of erection, including the thalamic nuclei, rhinencephalon, limbic structures and paraventricular nucleus. Superimposed on this hypothalamo-spinal circuit are higher centers, including the gyrus rectus, cingulate gyrus and hippocampus; these areas are all capable of modifying the erectile response, although their exact function has not yet been elucidated. In recent years, evidence has been building that injectable contraceptive depot medroxyprogesterone acetate (Depo-Provera or DMPA) is associated with an increased risk of HIV infection.
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Studies have indicated that one out of every three men over the age of 50 have erectile dysfunction (ED) and up to 40 percent of all men over age 40 will experience ED at some time in their lives. Most men will experience trouble getting or maintaining an erection at some point in their lives.
What can you do to address a condition that involves the brain, nerves, hormones, and blood vessels, as well as emotions? Once you have high blood pressure, also known as hypertension, you will need to go on medications to control that condition. Dozens of other drugs commonly used to treat high blood pressure as well as hypertension-related heart failure are also rendering men impotent. For more information about the dangers of eating salt check out Salt Kills and Salt: Black America’s Silent Killer by Surender R.
The ability to function sexually helps men define their role and shapes their identity.Loss of erectile function can be devastating. But this psychological factors have only second turn in the ED as the primary cause will be some other causes, leading to it. It’s estimated that 25 percent of all cases of ED have medication as their underlying cause. But the truth is that Erectile dysfunction(Male infertility) is not an inevitable consequence of aging. It strikes 5 percent of men who are 40 years old, but that number rises to 15 to 25 percent for those age 65 and older.
Impaired sexual health in an otherwise healthy man of 40-50 years could be a warning sign for heart disease, diabetes, high cholesterol, high blood pressure, and arthrosclerosis. The study found that men with ED were twice at a risk of dying due to related heart disease, as those without ED. Your arteries responsible for carrying blood flow to different parts of the body, including penis, gradually become narrowed by vascular disease. You may not be able to achieve or maintain an erection if blood flow to your penis is constricted. These cylindrical structures form the bulk of the penis and fill with arterial blood under pressure at the time of erection. The trabeculae constitute the walls of these spaces, and comprise smooth muscle and a fibroelastic framework of collagen in almost equal quantities.
At its proximal portion, it expands to form the bulb, which curves upwards through the urogenital diaphragm to reach the apex of the prostate gland.
These have two important functions: to facilitate ejaculation by their rhythmic contractions, and to empty the bulbar urethra after voiding, thereby preventing postmicturition dribble.
Division of this structure makes the penis appear longer in its flaccid state, but this does not enhance the proportions of the organ when erect. In the pelvis, the internal pudendal artery passes beneath the sacrospinous ligament and over the sacrotuberous ligament, and gives off the perineal artery in Alcock's canal, where it runs under the superficial transverse perineal muscle and the symphysis pubis (Figure 7). It then runs distally in the center of each corpus while giving off numerous helicine branches. The superficial system allows blood from multiple superficial veins to drain into the superficial dorsal vein, which itself drains into the left external branch of the internal saphenous vein. In turn, these nodes, which may become secondarily involved in patients who have carcinoma of the penis (Figure 13), drain to the external and internal iliac lymphatic chains. Exiting through the sacral foramina, these nerves pass forward lateral to the rectum as the nervi erigentes to reach the pelvic plexus. Messages are integrated in the medial preoptic area where dopaminergic neurons are important. Diseases specifically affecting these structures include Parkinson's disease, multiple system atrophy and stroke, all of which are often associated with erectile dysfunction. This topic and many other salt related diseases are reported in a new book, Salt: Black America’s Silent Killer by heart surgeon Dr.
No wonder tens of millions of men are now spending up to $5 billion a year on ED drugs including Viagra, Cialis and Levitra. Despite a man being sexually aroused or stimulated, not enough blood flows to his penis to trigger an erection. One solution that won’t cost you a dime is to simply hold the salt and avoid salty processed foods.
That alone can cause erection challenges, since high blood pressure can damage arteries thereby impeding blood flow to the penis. The most popular medication prescribed for hypertension is thiazide diuretic (hydrochlorothiazide) due to its relative safety. Considering the fact that drugs that deal with high blood pressure and heart disease are selling at an even greater rate than ED drugs, one can only assume that even more men are going to wind up needing both types of medications unless they cut back on salt and lower their risk for hypertension.
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The rapid filling of the cavernosal spaces compresses venules resulting in decreased venous outflow, a process often referred to as the corporeal veno-occlusive mechanism. One of the reasons for ED could be high cholesterol, which is deposited in the arteries in the form of plaque.
Fused distally for three- quarters of their length, they separate proximally to fuse with each ischial tuberosity of the pelvis. In its distal portion, the penile skin extends forward to form the prepuce before folding backwards and attaching to the corona of the glans penis (Figure 5).


The intermediate venous system lies beneath Buck's fascia and comprises the deep dorsal vein and the multiple circumflex veins. Conditions that obstruct these lymphatic channels, such as metastatic prostate cancer, may result in gross penile and scrotal edema. In this location, preganglionic fibers relay in ganglia, and postganglionic non-adrenergic, non-cholinergic (NANC) fibers pass in the cavernous nerves to the corpora cavernosa.
The pudendal nerve enters the perineum through the lesser sciatic notch at the posterior border of the ischiorectal fossa and runs in Alcock's canal towards the posterior aspect of the perineal membrane. Multiple fascicles fan out distally, supplying proprioceptive and sensory nerve terminals to the dorsum of the tunica albuginea and skin of the penile shaft and glans penis. Norepinephrine (noradrenaline) and serotonin have also been identified as neurotransmitters in this region. The causes for this lack of blood flow are more complex, ranging from psychological to medical. Nerve impulses in the brain, spinal column, around the penis and response in muscles, fibrous tissues, veins and arteries in and around the corpora cavernosa constitute this sequence of events.
The combination of increased inflow and decreased outflow rapidly raises intracavernosal pressure resulting in progressive penile rigidity and full erection. Plaque accumulation in the arteries causes blockage of blood flow to different parts of the body. The spongiosum is composed of sinusoidal spaces of larger dimensions than those of the corpora cavernosa and with less smooth muscle. This vessel pierces the pelvic floor adjacent to the inferior ramus of the ischium near the bulb of the urethra and gives off the bulbar, urethral, dorsal and cavernosal branches before reaching the corpus cavernosum to form one element of the paired dorsal arteries (Figure 8).
The tonic contraction of the smooth muscle walls (Figure 10) normally allows only small amounts of blood into the lacunar spaces, thereby maintaining penile flaccidity. This system drains blood from the glans, corpus spongiosum and the distal two-thirds of the corpora.
These nerves are vulnerable during procedures such as abdominoperineal resection of the rectum and radical prostatectomy (Figure 15). At this point, it gives off the perineal nerve with branches to the scrotum and the rectal nerve supplying the inferior rectal region. Efferent pathways enter the medial forebrain bundle and pass caudally into the mid-brain tegmental region near the lateral part of the substantia nigra.
Americans’ sex life is in big trouble and a tiny condiment that most of us use every day is partially to blame. Injury to any of these parts which are part of this sequence (nerves, arteries, smooth muscles, fibrous tissue) can cause Erectile Dysfunction.Some types of blood pressure drugs can actually cause erectile dysfunction or impotence. The tunica albuginea surrounding the spongiosum is flimsy compared with that of the corpora, but the spongiosum is nevertheless capable of an erectile response. Relaxation of the muscular walls of these vessels initiates the hemodynamic changes that result in penile erection.
Caudal to the mid-brain, the efferent pathway travels in the ventrolateral part of the pons and medulla, passing down to the sacral spinal centers via the lateral funiculus of the spinal cord. It enters the pelvis beneath the suspensory ligament, which suspends the corpora from the undersurface of the pubic arch and drains into the dorsal venous complex at the urethroprostatic junction. Activation of the parasympathetic neurons, located in the spinal cord, leads to intrapenile release of nitric oxide, mainly by neural terminations.
Emissary veins in the proximal third of the penis join to form one or two cavernosal veins which pass between the bulb and crus of the penis to drain into the internal pudendal vein (Figure 11).
A research says that herbal treatment is the highest adaptability rate among the hypertension patients.High blood pressure is a common cause of erectile dysfunction (impotence) is damage to the lining of the arteries to the penis, so that they fail to open up and let the blood in to strengthen an erection.
Blood pressure can damage your arteries by causing them to become thicker, or even to burst. This can restrict blood flow to your penis, which may then cause erectile dysfunction.Some blood pressure medicines can also cause erectile dysfunction. If you are taking either of medicines and are worried about erectile dysfunction.High blood pressure is known as the “silent killer” because normally, people who are suffering from it may be unaware until it`s either critical and they need a heart bypass op, some other drastic measure, or when it`s too late. On the other hand, if men pluck up courage to go to their doctor about it, viewing it as a probable symptom of high blood pressure, impotence may save their life as well as their marriage.If blood pressure levels are normal then a person would need to discuss with their doctor other possible reasons that are causing impotence. On the other hand, if one has already been diagnosed as suffering from high blood pressure, impotence could be caused by the prescription drugs.High blood pressure in the blood vessels actually causes damage to small arteries in the penis. Normally, these arteries dilate in response to sexual stimulation, allowing more blood to flow into the spongy tissue of the penis to produce an erection.
It is thought that excessive pressure on these arteries may cause tiny tears, which the body then repairs.
In response to these tears, the healed arteries become thicker, allowing them to better resist further damage. These thicker arteries, though, aren’t able to respond as fast, or as completely, to demands for extra blood, so they become a sort of dam in the flow of blood to the erectile tissues of the penis.



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Comments »

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