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Problems remembering or concentrating "Smoking delivers nicotine and other vasoconstrictors that close down the blood vessels" of the penis, explained Dr. Jack Mydlo, chairman of urology at Temple University School of Medicine and Hospital in Philadelphia. In the study, Selvin's team collected data on more than 2,100 men who participated in the National Health and Nutrition Examination Survey. Men who said they were "sometimes able" or "never able" to achieve and keep an erection were classified as having erectile dysfunction, while men who said they were "always or almost always able" or "usually able" were not. Out of 117 men who were suitable for taking sildenafil, the acceptance of sildenafil as a treatment option is high, 98.3% (115/117). Sildenafil was successful in treating ED in 91.3% (84/92) of this study population. At the end of the study period, 79.7% (59/74) of men wanted to continue treatment with sildenafil. The side effect profile of sildenafil in this study would appear to be different from previous published data [6] in that the incidence of headache, flushing, dyspepsia and abnormal vision is higher, but in the absence of a control group the significance of this is uncertain. It must be noted that 13% of men who reported side effects at Visit 2 reported complete lack of them at Visit 3. It is of interest that there is a 2% incidence each of thirst and 'dazed feeling' (reported by patients as a 'muzzy head'). The physiology underlying this is unclear, although it could be related to PDE inhibition in the brain, where the various PDE isoenzymes are in abundance [11]. The use of oral therapy has long been preferred over invasive procedures such as injection therapy for erectile dysfunction. We review the pharmacology, efficacy and side effects of the newest agents available for oral therapy: the PDE-5 inhibitors sildenafil, vardenafil and tadalafil. buy Viagra 150mg here viagra without prescription

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