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General Practitioner's Section |
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SSA to be Added While Treating Erectile
Dysfunction
O P Kapoor |
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Today in private practice, the symptom of Erectile
Dysfunction (ED) is extremely common. One can prescribe sildenafil
in a dose of 50/100 mg. It takes about 2 hours to act. Now, Taldanafil
is already in the market with doses of 10-20 mg and it works for
24 hours.
About 20-30% of the patients will not respond to above drugs. They can be offered
tab Apomorphine. This drug works in 18 minutes. Once in a while, when nothing
works, prostaglandin applicap should be inserted into the urethra which works
with immediate effect.
Most of the doctors will come across patients, who will report no success after
the use of sildenafil. This is due to the fact that most doctors do not know
that unless there is sufficient sexual arousal (SSA) the drug alone does not
give good results.
In short, the patient cannot just swallow a tablet and expect the drug to act,
when he continues to read about politics in the newspaper, while his wife is
busy in the kitchen feeding the children This is usually what our patients do,
because the correct use of the drug has not been properly explained to them.
A strong sexual stimulation is a must when the above medicine is being used.
This will need planning. |
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DON'T EXPECT TOO MUCH FROM VIAGRA
The expectations of patients taking sildenafil (Viagra)
are high, and the higher the expectation the more extreme
is the disappointment with failure. Tomlinson and Wright
interviewed 40 men who had been prescribed sildenafil for
erectile dysfunction. They found that the emotional and
social ramifications of impotence were greater than expected:
impotence carried a sense of emasculation and a decline
in confidence, and affected the participants' relationship
with their partners, friends, and work colleagues. Failure
of treatment caused some patients additional anguish; for
many, it confirmed their lack of self worth. Less sensational
media reporting of the benefits of sildenafil would have
lowered expectations, to the patients' benefit, say the
authors.
BMJ, 2004; 328 : 1037.
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