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Duplex ultrasound is used to evaluate erectile tissue. It is used to evaluate blood flow, venous leak, signs of atherosclerosis, and scarring of erectile tissue. An erection is induced and the ultrasound is used to see vascular dilation and measure blood pressure in the penis. HealthDay Reporter The cyclic nucleotide phosphodiesterases (PDEs1) described in this review are a family of related phosphohydrolases that selectively catalyze the hydrolysis of the 3? cyclic phosphate bonds of adenosine and/or guanosine 3?,5? cyclic monophosphate. The structure of cAMP and the bond hydrolyzed is shown in Fig. 1. These enzymes are often referred to as class I cyclic nucleotide PDEs to differentiate them from class II enzymes. Class II enzymes are found in many species including mammals and will also catalyze the hydrolysis of the phosphodiester bond. However, in general, the Class II enzymes do not show the same substrate selectivity as the class I enzymes and much more is known about the class I enzymes. They typically contain stearate, croscarmellose, calcium hydrogen phosphate (anhydrous), and microcrystalline cellulose. After all, this can be not the entire formulation as it is a closely guarded secret of each manufacturer. Future treatments for erectile dysfunction focus on providing medications that are more effective, work rapidly, and have fewer, if any, side effects than currently available treatments. Currently there are three oral medications available to treat ED - Cialis, Levitra and Viagra. A number of pharmaceutical companies are researching new treatments for ED, and many new options may be just around the corner. These include: Corpus Cavernosometry Orgasm Fig. 2: Cellular perspective of the erection pathway. The signal (nitric oxide) is released from nerve endings or from endothelial cells and activates a cascade reaction, which ultimately leads to an increased cellular concentration of cGMP (cyclic guanosine monophosphate). This second messenger molecule induces a series of events that lead to smooth-muscle relaxation through a reduction in the intracellular calcium ion concentration. The enzyme PDE-5 (phosphodiesterase type 5) reverses this effect by metabolizing the cGMP to GMP rapidly. The clinically important inhibitors of this enzyme (sildenafil, vardenafil and tadalafil) all act to promote smooth-muscle relaxation by their ability to allow cGMP to accumulate when nitric oxide is released, as is the case when sexual stimulation is present. Photo: Christine Kenney All men at one time or another will experience ED. Only if the problem becomes persistent -- occurs more than 50% of the time, or becomes a source of distress for you or your partner should you be concerned and consider seeking medical advice and treatment. For men whose erectile dysfunction is caused by psychological problems, therapy may be needed. Taking Viagra Won't Spur Risky Sexual Behavior Other factors leading to erectile dysfunction are diabetes mellitus (causing neuropathy) or hypogonadism (decreased testosterone levels due to disease affecting the testicles or the pituitary gland). Physical symptoms related to excessive stress are breathlessness and loss of sexual drive, headaches, and infections, indigestion, tingling of hands and feet and changes in sleep pattern. Excessive stress can also lead to the some mental problems like memory lapses, difficulty in making decisions, and lack of concentration. The process of achieving an erection is complex and problems may occur for a variety of reasons. These problems can be psychological, physical, or a combination of the two. Penile implants Its incidence is expected to rise due to an aging population, increases in diabetes, smoking, alcohol consumption, obesity and larger numbers of patients being operated on for prostate cancer. It has been estimated that only 10 percent of men with ED visit their doctor for advice or treatment. more Implanted devices, known as prostheses, can restore erection in many men with ED. Possible problems with implants include mechanical breakdown and infection, although mechanical problems have diminished in recent years because of technological advances. Penile biothesiometryThis test uses electromagnetic vibration to evaluate sensitivity and nerve function in the glands and shaft of the penis. A decreased perception of vibration may indicate nerve damage in the pelvic area, which can lead to impotence. Exposure to high levels of a controversial chemical found in thousands of everyday plastic products appears to cause erectile dysfunction and other sexual problems in men, according to a new study published Wednesday. "The association of erectile dysfunction with diabetes and other cardiovascular risk factors can serve as a powerful motivator for men in whom diet and lifestyle changes are really indicated," said study author Elizabeth Selvin, a postdoctoral fellow at Johns Hopkins.

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