4845 Knightsbridge Blvd, Suite 200, Columbus, Ohio 43214 (614) 442-3000

ERECTILE DYSFUNCTION - IMPOTENCE - NOT BEING ABLE TO BE A MAN

A fear that at some time affects almost all adult men. This effects how we (men and women) react to one another. Tolstoy described it best, "the tragedy of the bedroom".

Medicine, psychology and basic science have given us many tools to deal with the problem. The most recent entry is Viagra (sildenafil), "The Pfizer Pill" that is taking the country by storm. This is a new class of treatment, a pill that works !

How does it work? Viagra is an enzyme inhibitor. It blocks the action of 5-phosphodiesterase. This results in the chemicals secreted by the nerve endings in the sex organs to accumulate. This causes the muscles in the blood vessels and erectile tissue to relax and fill with blood. In men this causes an erection. This occurs only when these nerves are stimulated either by psychologic or physical, sexual action. When the stimulation stops the erection goes down. No cases of prolonged erection (priapism) were reported in the clinical trials. Viagra only affects erection. It does not stimulate the libido (sex drive) or orgasm.

The side effects of Viagra are caused by reaction of other phosphodiesterase (I - IV, VI - VII). to the drug. These are found in other blood vessels : the retina of the eye, smooth muscle of the digestive tract, muscle of the heart and many other organs. Fortunately, the reaction of the other phosphodiesterase is minimal in most people. Viagra should not be used in patients who take medications containing NITRATES. Nitrates are generally used for patients who experience heart pain (angina), this is caused by poor blood flow through the arteries of the heart. When Viagra is taken with nitrates very severe low blood pressure may occur and could be fatal in patients experiencing angina.

The Pfizer Company did and is doing an excellent job with research and development of Viagra. I know, as I am involved in the ongoing clinical trials. Viagra will be of great aid to many men with impotence, erectile dysfunction. However, it must be used wisely. Viagra is a very good tool within our resources to deal with the problem, but how it is used will determine if an individual patient will have success. A careful evaluation of the person and his problem must be done !

Many disease-related problems in addition to normal aging can cause erectile impotence. These must be carefully studied and understood before treatment is chosen. If we cover the problem of impotence and erectile dysfunction with a layer of Viagra - much like a coat of paint - we will do a disservice to the patient and to a very useful medicine.

Included is a list of medications that contain nitrates and with which Viagra cannot be used. For an appointment to be evaluated call (614) 442-3000

Riverside Urology Inc.

4845 Knightsbridge Blvd

Suite 200

Columbus, Ohio 43214

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Herbert Riemenschneider, M.D.