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Category: Big Erections | Author: admin 14.03.2016
Besides the above pharmaceutical agents, there are also numerous herbal products and nutritional supplements that are advertised in the market for helping erection. So far in Greece, four different oral drugs have been available for ED treatment: Avanafil, (Spedra ??),  vardenafil (Levitra??), sildenafil (Viagra??, and recently its generics Sildenafil Actavis??, Sildenafil Pfizer??, Sildenafil Sandoz??) and tadalafil (Cialis??). All above preparation forms are indicated to be taken by the patient ‘on demand’, that is about one hour before sexual intercourse, whereas  Avanafil is recommended to be taken about 15-30 minutes before the sexual act.
Their efficacy rate amounts to 70%, while this drops to 50% in patients who have severe concomitant diseases, such as diabetes mellitus, neurological diseases or after radical prostatectomy for prostate cancer. These drugs are absolutely contra-indicated in patients who receive nitrates (drugs for coronary disease), since drug interaction may significantly reduce blood pressure. The injection is done with a special syringe and fine insulin needle directly into the two ‘cylinders’ (corpora cavernosa) along the penis. Extracorporeal Shock Wave Therapy (ESWT) is a painless and effective therapeutic method to treat erectile dysfunction of exclusively vascular etiology.
As for efficacy, studies have shown that 60-70% of patients who respond to oral ED drugs will not need ED drugs any more after the application of sound waves and will have satisfactory sexual intercourse. Penile prosthesis is a device placed inside the penis to help the male achieve erection for a successful sexual intercourse. For healthcare professionals: Prescribe, approve renewals and re-order common preparations with ease. For patients and care givers: Pick up and fill a new prescription or refill a current prescription.
Virag announced that the papaverine intracavernous injection can cause penile erection by immediately increasing penile blood flow. However, there is no scientific evidence that these preparations are more effective than placebo. In case of psychogenic erectile dysfunction, drug therapy can help only if combined with therapy by the Sexologist. Tadalafil has an action of 36 hours, while the other three drugs have a duration of 6-12 hours. This form is indicated for patients who have frequent sexual activity or suffer from benign prostate hyperplasia (BPH). Most common side effects are headache, indigestion, muscle pain; more rare side effects are nasal congestion and eye disorders. It is an injection of various vasodilating agents that improve penile blood perfusion (papaverine, phentolamine and alprostadil). With regard to patients who do not respond to ED drugs, 70% of them will respond to the drugs after the application of sound waves. It is a therapeutic option for patients who have tried all other therapies (drugs, penile injections) without any success. When injected into the penis (intracavernosal), it increases blood flow to the penis, which results in an erection.phentolamine should not be used as a sexual aid by men who do not have erectile dysfunction.
Needless to say that many of these products sold online (on the Internet) are particularly dangerous! This does not mean that this is how long the erection will last, since these agents do not induce erection by themselves but only after sexual stimulation.
Prostate hyperplasia is the most common disease causing urinary difficulty in men above 50 years old. Even if occurring, these side effects are mild and subside immediately after the regimen is discontinued. The injection is done by the patient himself, after he has been trained by the Urologist and after having together decided on the proper individualized dosage.
The application of soundwave technology on the penile cavernous bodies promotes the formation of new penile vessels (neoangiogenesis), increases blood flow, improves penile blood perfusion and ultimately results in achieving better quality erections. If the medicine is not used properly, permanent damage to the penis and loss of the ability to have erections could result.Phentolamine may also be used to reverse the effects of an anesthetic medicine in soft tissues, such as the lips and tongue.
The first drug in the market was the injectable prostagladine E1, but the real breakthrough took place in 1998 with sildenafil for oral administration. They are all vasodilating agents; by improving penile blood perfusion, they achieve better penile rigidity and longer erectile duration.

So, what these agents actually achieve is allowing every patient to get involved in sexual activity whenever they wish to within the hours of their action. Tadalafil has been proven to help not only erection but also urination in BPH men, when there are symptoms such as urinary frequency, urgency or dysuria (painful urination). The drug acts topically, and erection is achieved 10-15 minutes following the injection, irrespective whether there is sexual desire. Malleable, or semi-rigid, prostheses are composed of two cylinders that are inserted within the two cavernous bodies, in order to achieve satisfactory penile erections.
A few years later, in 2003, two more pharmaceutical agents came out with the same indication: tadalafil and vardenafil. It should be pointed out that food intake affects negatively the action of Sildenafil and Vardenafil (in the form to be swallowed, but not in the oral disintegrating form), whereas Tadalafil is not at all affected by food intake.
After an experience of 18 years, ED drugs have proven to be safe as long as they are used according to the therapist physician’s instructions. In patients with severe erectile dysfunction, the success rate of the method drops to 50% and therapeutic efficacy reduces over time.
These drugs have been proven to significantly help erectile dysfunction (ED), and are administered ONLY WITH MEDICAL PRESCRIPTION. Avanafil is not affected by food intake either; however, its absorption is delayed when a high-fat meal  has preceded. Besides, two of them (sildenafil and tadalafil) are already used on a chronic daily basis for the treatment of another severe disease, pulmonary hypertension.
Whenever the patient wants to achieve an erection, he presses the pump and the normal saline inside the reservoir ‘inflates’ the cylinders located inside the cavernous bodies. When intercourse is completed, the man presses again the pump and the fluid flows back to the reservoir and erection subsides.
For phentolamine, the following should be considered:AllergiesTell your doctor if you have ever had any unusual or allergic reaction to phentolamine or any other medicines. It should be pointed out that what we want to achieve with the injection is erection of 30 minutes to 1 hour at the most.
The advantage of penile prostheses is that they have an excellent aesthetic result; however, they have a much higher cost compared to non-inflatable prostheses.
Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. Therefore, the patient should be well informed so that, in case priapism occurs, he immediately informs his physician to be treated as an emergency case. For non-prescription products, read the label or package ingredients carefully.PediatricAppropriate studies have not been performed on the relationship of age to the effects of phentolamine for the reversal of soft-tissue anesthesia in children younger than 6 years of age.
It should be known that erection prolongation of more than 6-8 hours may cause penile impairment and permanent severe erectile dysfunction (fibrosis within the corpora cavernosa). Safety and efficacy have not been established .GeriatricMany medicines have not been studied specifically in older people.
The patient can resume to his daily activities a few days after surgery and can start sexual activity after one month. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people.
It has been found that 30-50% of patients who select this form of therapy will continue using it after the first 3 months.
When being well-informed, both patients and their partners present a satisfaction rate over 90%.
Complications are rare, with most severe complication the infection or mechanical failure of the prosthesis; in such a case, the prosthesis has to be immediately removed.
Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.Interactions with MedicinesUsing phentolamine with any of the following medicines is usually not recommended, but may be required in some cases.
If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.TadalafilUsing phentolamine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. Although used worldwide as the most effective ED treatment, “tri-mix” is not available in the market.
Out of its 3 ingredient drugs, only alprostadil is available in pharmacies, as it is the only agent prescribed and officially sold  (commercial brand: Caverject??) ONLY WITH MEDICAL PRESCRIPTION.

Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.Other Medical ProblemsThe presence of other medical problems may affect the use of phentolamine. The dose is individualized for each patient, with a normal dose of 5-20?g and the maximum daily dose amounting to 40?g. Using a sterile needle, inject the medicine slowly and directly into the base of the penis as instructed by your doctor.
The injection is usually not painful, although you may feel some tingling in the tip of your penis. If the injection is very painful or you notice bruising or swelling at the place of injection, that means you are injecting the medicine under the skin. Stop, withdraw the needle, and reposition it properly before continuing with the injection.After you have completed the injection, put pressure on the place of injection to prevent bruising. This helps the medicine spread to all parts of the penis, so that it will work better.phentolamine usually begins to work in about 10 minutes. You should attempt intercourse within 2 hours after injecting the medicine.To reverse the effects of a soft-tissue anesthetic medicine, a dentist or other trained health professional will give you phentolamine. If your dose is different, do not change it unless your doctor tells you to do so.The amount of medicine that you take depends on the strength of the medicine. Also, do not use phentolamine more than two days in a row or more than three times a week.StorageStore the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
If too much is used, the erection may become so strong that it lasts too long and does not reverse when it should. If the effect is not reversed, the blood supply to the penis may be cut off and permanent damage may occur.Contact your doctor immediately if the erection lasts for longer than 4 hours or if it becomes painful. This may be a sign of priapism and must be treated right away to prevent permanent damage.If you notice bleeding at the site when you inject the medicine, put pressure on the spot until the bleeding stops. If it doesn't stop, check with your doctor.It is important for you to examine your penis regularly. Check with your doctor if you find a lump where the medicine has been injected or if you notice that your penis is becoming curved.
These may be signs that unwanted tissue is growing (called fibrosis), which should be seen by your doctor.phentolamine Side EffectsAlong with its needed effects, a medicine may cause some unwanted effects. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. This is no cause for concern.Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.Call your doctor for medical advice about side effects. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen.
Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.The use of the Thomson Healthcare products is at your sole risk.
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