Oct 24

Diagnosis of ED: History

Detailed sexual and medical history, including:
Nature and frequency of ED
Risk factors for ED, eg:

Concurrent disease
Drug abuse
Psychiatric illness

Risk Factors for ED

Hypertension
Hyperlipidemia
Hypogonadism
Endocrine disorders
Smoking
Alcohol abuse
Trauma or surgery to the pelvis or spine
Depression
Drug abuse
Anemia
Vascular disease
Peyronie’s disease
Vascular surgery

Drugs Associated with ED

Alcohol
Estrogens
Antiandrogens
H2 receptor blockers
Anticholinergics
Ketoconazole
Antidepressants
Marijuana
Antihypertensives
Narcotics
ß-blockers
Psychotropics
Cigarettes
Cocaine
Spironolactone
Lipid-lowering agents
NSAIDs
Cytotoxic drugs
Diuretics

Diagnosis of ED: Physical Examination

Assessment of secondary male sexual characteristics
Femoral and lower extremity pulses
Focused neurologicexamination
Perianal sensation
Sphincter tone
Bulbocavernosus reflex
Examination of penile vasculature
Evaluation of prostate size by digital rectal exam
Detection of Peyronie’s plaques

Laboratory Tests

Morning serum testosterone specimen
Serum prolactin

Tests for other systemic disease:

Complete blood count
Urinalysis
Serum creatinine
Glucose
Lipid profile
Thyroid function tests

Special Tests: Indications

Vasoactive agent injection

Intracavernosal injection therapy
Penile prosthesis implantation
Vascular surgery

Nocturnal penile tumescence, eg, Snap-Gauge, Rigiscan

Screen for psychogenic vs organic ED

Duplex ultrasonography
Vascular surgery

Post Workup Patient Management

Patient education
Assessment of etiology and discussion of treatment options

Lifestyle modification: Diet and exercise; stress reduction; alcohol, smoking, and illicit drug use if an issue
Trial of chosen therapy

Treatment Options for ED:
Oral medications at online canadian pharmacy
Cialis Soft Tabs – Just like regular Cialis but specially formulated, these pills are soft and dissolvable under the tongue. The effect of this is more direct absorption into the bloodstream, rather than through the stomach. Result – a powerful, lasting effect of up to 36 hours.
Viagra Professional – Viagra is a prescription drug used to treat erection difficulties, such as erectile dysfunction (ED).
Viagra Soft Tabs – Viagra Soft Tabs are mint flavored soft tablets for the treatment of male erectile dysfunction. They are equivalent to regular Viagra®, however due to their soft formulation, they are absorbed directly into the bloodstream. As such, they contain a much smaller dosage of Sildenafil Citrate to achieve the same result.
Cialis – Cialis, or Super Viagra, is used to treat erectile dysfunction, more commonly known as impotence. A man is impotent if he cannot achieve or sustain an erect penis for sexual activity.
Generic Viagra – Generic Viagra, containing Sildenafil Citrate, enables many men with ED to achieve or sustain an erect penis for sexual activity.
Levitra – LEVITRA is a new FDA-approved oral prescription medication for the treatment of erectile dysfunction (ED) in men