Статьи Март 27th, 2009

• SURGERY SOLUTION OF ERECTION PROBLEMS: HOW INFLATABLE IMPLANT INSTALLS

  Дата: 2009.03.27 | Категории: ПСИХОЛОГИЧЕСКИЕ ТРУДНОСТИ ПРИ ДИАБЕТЕ | Комментарии: 0

  Surgery to install an inflatable implant is usually done under a general or spinal anesthetic, and not a local, because the operation is more extensive. And with this type of implant, a two to four day hospital stay is the norm.
  

  The surgeon gets access to the body through the scrotum, or through an incision in the lower abdomen, above the penis. He then cuts into the corpora cavernosa. All the components are usually inserted through one incision and placed in their proper locales. Before the patient is sewn up, the reservoir is filled with fluid—usually a solution of water and contrast material so the fluid will show up on an X-ray. Then the tubing which connects each part is hooked up. And all the components are tested to make sure they work.
  

  Some surgeons prefer to leave the prosthesis partially inflated, others leave it completely flaccid. If s typical for a catheter to be inserted into the bladder for a day or so. And while the patient is still under the anesthetic, the doctor will pump the implant up and down several times to make sure everything is in working order.
  

  In general, it takes a little longer to recover from inflatable implant surgery than from an operation to put in a semirigid prosthesis, because the surgery takes longer and is more complicated. If s typical to have a bruised and swollen penis and scrotum following surgery (ice bags on the area can help), and if s common to feel a burning sensation the first few times that you urinate. You’ll want to take a week or two off from work, and to take it easy while recovering.
  

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• THE VIRILITY-ENHANCEMENT DIET: THE FISH CONNECTION

  Дата: 2009.03.27 | Категории: ПСИХОЛОГИЧЕСКИЕ ТРУДНОСТИ ПРИ ДИАБЕТЕ | Комментарии: 0

  The concept is very simple: eating fish at least once a week will lower your cholesterol, enhance overall vascularity, and improve erectile health in the process. New studies on the effects of fish eating support the idea that polyunsaturated fatty acids are responsible for this. The omega-3 fatty acids, found primarily in the oils of the fish, lower blood triglyceride levels. The omega-3s seem to make blood less likely to coagulate, which, in turn, makes it less likely to clot. They accomplish this by raising the levels of prostacyclin in the blood, thereby making the arterial walls relax. At the same time, they lower the levels of thromboxane, another chemical messenger which is responsible for the constriction of blood vessels.
  

  One study of 1,300 men showed that those who consumed at least eight to nine ounces of fish weekly (and that was mostly canned tuna) had an incredible 40 percent lower risk of a fatal heart attack than those men who ate little or no fish.
  

  To get the fullest benefits of all fish has to offer, I suggest that you eat it two or three times a week. Fatty species, such as herring, cod, mackerel, salmon, and sardines, contain greater quantities of omega-3s than do leaner varieties. But if the idea of eating that extra piece of fish each week is just not appealing to you, there are other ways to get the omega-3s you need. Flaxseed may be the source that will work for you.
  

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• ERECTILE DYSFUNCTION: PSYCHIATRIC MEDICATIONS

  Дата: 2009.03.27 | Категории: ПСИХОЛОГИЧЕСКИЕ ТРУДНОСТИ ПРИ ДИАБЕТЕ | Комментарии: 0

  ED is not only one of the most troubling side effects of many psychiatric drugs, it is also the least discussed. «I thought it was just me,» a patient said after learning that an antidepressant that he had been taking daily for two years caused his ED. «I was embarrassed to talk to you about it. And I didn’t know if there was anything you could do for it, anyway.»
  

  If ED is going to become a problem for men undergoing pharmacotherapy with tranquilizers or antidepressants, the trouble usually begins during the first month of treatment. For many men who experience this initial side effect, and then stay on the program long enough to benefit from diminished anxiety and/or reduced depression, there will eventually be a reawakening of sexual interest and, consequently, improved sexual performance.
  

  Over time, however, the sexual picture may change, again because of the drugs. Many of the treatments for psychiatric-related disorders negatively affect sexual response by impacting the autonomic nervous system, which controls the genitals. Other psychiatric drugs can block nerve function, making it difficult, or even impossible, to achieve an erection or ejaculation. High doses of tranquilizers prescribed for anxiety and depression not only cause ED, they can also be responsible for the lessening of libido (sexual desire), an inability to ejaculate, and gynecomastia (breast enlargement in men).
  

  The popular new class of depression-fighting drugs, SSRIs, such as fluoxetine and sertraline, also inhibit sexual function. SSRIs are selective serotonin-reuptake inhibitors, a group of drugs which affect the neurotransmitter, or brain chemical, serotonin, which affects mood. These medicines often contribute to ED, diminish sex drive, and block orgasm. This latter problem is so widespread with Prozac, Paxil, and Zoloft, three of the most widely used SSRIs, that I often prescribe low dosages of them to men complaining of premature ejaculation. Current estimates of men taking SSRIs who have erectile problems range from 9 percent to 24 percent.
  

  While it sometimes happens that sexual problems diminish after a man has adjusted to the drug he is taking, it is usually the exception to the rule. Taking a drug «holiday,» or having sex when the drug is at its lowest concentration in the body, are alternatives that work for some men (see pages 165 and 166-68). For others, yohimbe (the pulverized bark of an African tree, available in health food stores or by prescription) or red ginseng can alleviate ED when taken in combination with their SSRI medications. Many of my patients have responded very well to changing from Prozac to either Wellbutrin or Serzone.
  

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• DEGREE OF PERSONAL SEXUAL SATISFACTION

  Дата: 2009.03.27 | Категории: ПСИХОЛОГИЧЕСКИЕ ТРУДНОСТИ ПРИ ДИАБЕТЕ | Комментарии: 0

  Any relationship is bound to have its physical ups and downs. However, a realistic appraisal of personal satisfaction is something that must be faced if a couple is to reach an enlightened connection. In the case of Rachel and Joshua, their sexual problem was, interestingly enough, related to the society in which they lived. A couple in their early twenties, they had been married for a year when they came to see me. Participants in an arranged marriage dictated by their culture, they were expected to have children as soon as possible. They told their respective families that they were seeing doctors to address their fertility problem.
  

  Sadly, whether fertility was an obstacle was a moot question. The fact was they had only achieved intercourse a couple of times. At his young age, Joshua was experiencing erectile dysfunction.
  

  «Our parents brought us together, we got married, and now we’re expected to have children,» Joshua told me with frustration rising in his voice. «We want to—of course. It’s just that I can’t perform regularly.
  

  I don’t understand it!»
  

  His physical exam revealed abnormally high cholesterol, which, I hastened to explain, very often contributes to ED as a man ages. I suspected that in Joshua’s case, the ongoing pressure to immediately build a family might be the major culprit and I suggested a consultation be with a sex therapist.
  

  After numerous sessions, the therapist reluctantly agreed that no progress had been made. It was at this time that Joshua and Rachel enrolled in the Vasomax study.
  

  My only concern in their case was that they had little frame of reference to compare before-and-after personal sexual experiences. «We’ve been together for a while now,» Rachel ventured, «and, despite the problems we’ve been having, we’ve been able to get to know each other in a very positive way. What I see this pill giving us is the opportunity to build on what we’ve already established. If we can get over this hurdle, I’m convinced that the love and affection we have for one another will move us forward to where we want to go.»
  

  Joshua nodded in agreement. «Rachel is right. We want to get past this dark period and move on—even if it takes us a while to do it.»
  

  Happily, the pill did for them what they hoped it would, and their joint feelings made the outcome the satisfying one they were hoping for. The personal satisfaction issues in this case were:
  

  • mutual frustration at the lack of a sex life
  

  • shared comfort in the basic relationship, based on compatibility
  

  • anticipation of exciting and fulfilling sexual experiences—as well as becoming first-time parents
  

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