tailieunhanh - Handbook of sexual dysfunction - part 6

Siêu âm Doppler Duplex unlikable Biểu diễn trong bệnh viện, hệ thống Knoll / Midus Siêu âm là Thiết kế Như hệ thống văn phòng dựa trên. Duplex Doppler siêu âm sẽ cho phép hình dung của các mạch máu ở những bệnh nhân đủ điều kiện để tái tạo phẫu thuật. | 166 Wylie and MacInnes penile blood flow. Unlike Duplex Doppler Ultrasonography performed in the hospital the Knoll MIDUS Ultrasound System is designed as an office-based system. Doppler Duplex sonography will allow for visualization of the vasculature in patients eligible for reconstructive surgery. Electrophysiological testing may be indicated in specific cases . nerve conduction studies GSA genital sensory analyzer . A consensus statement of recommendations has been published following the second international consultation on sexual dysfunction 21 . TREATMENT OPTIONS FOR ED IN MEN Guidelines for treatment have changed considerably over the past decade and will continue to do so as new drugs and treatment options become available and are evaluated. Treatment can be subdivided into first second and third line therapies and includes drug therapies as well as psychotherapies and surgery. All patients should be provided with some general information about ED which will include normalizing the condition which can be reassuring for the man and his partner. The role of organic and psychological factors should be described and unbiased information provided on all suitable treatment options. Pharmacotherapy for Men with ED Few licensed drugs are currently available for the treatment of men with ED. Those that are available elicit their effect by one of two mechanisms. The agent boosts either the neuronal control mechanism or the local control mechanism 13 . As we shall see oral therapies can have their effect on either system whereas the intracavernosal and intraurethral systems act locally to produce an erection. First Line Oral Therapies Oral agents used to treat ED should be reliable have minimal side effects and be simple to use 22 . The oral therapies currently licensed for ED are the phosphodiesterase 5 inhibitors PDE5 inhibitors which have a peripheral mechanism of action and apomorphine which acts centrally. These agents require sexual stimulation to initiate .