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Park min soo wife sexual dysfunction

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As many international guidelines Park min soo wife sexual dysfunction on objective evidence are available, the committee decided to adapt these guidelines for local needs instead of developing a new guideline.

Considering the extensive research activities on ED in Korea, data with a high level of evidence among those reported by Korean researchers have been collected and included in the guideline development process. Recent epidemiological data have shown a high prevalence and incidence of erectile dysfunction Park min soo wife sexual dysfunction worldwide.

The overall prevalence of ED was shown to be Risk factors for ED include age, diabetes, hypertension, obesity, lack of exercise, dyslipidemia, smoking, depression, lower urinary tract symptoms, and pelvic surgery. In addition, the duration of diabetes, fasting glucose level, and HbA1c level were associated with the severity of ED.

After controlling for subject age, census region, and 9 concurrent diseases, the odds ratio was 1. Smoking is a risk factor of ED by causing injury to the vascular endothelial cells. In the MMAS, the risk of Park min soo wife sexual dysfunction ED was shown Park min soo wife sexual dysfunction significantly increase in smoking patients with coronary artery disease or hypertension, and Park min soo wife sexual dysfunction odds ratio for ED in smokers versus non-smokers was 1.

In addition, passive exposure to cigarette smoke may act as an additional risk for ED both in non-smokers and Park min soo wife sexual dysfunction. The prevalence odds ratio adjusted for potential confounders was 2. In addition, the adjusted incidence density ratio of depressive mood was 1.

In a study that was conducted on more than 10, subjects in a group of western countries, the odds ratio for ED was shown to be 7. ED may occur Park min soo wife sexual dysfunction pelvic surgery for curative treatments, such as prostate cancer, bladder cancer, and colorectal cancer. Age and preoperative erectile function EF are the main factors that can predict the recovery of postoperative EF. A nerve-sparing technique should be applied to preserve postoperative EF.

Antihypertensive drugs and psychotropic agents, such as antidepressants, may cause ED due to Park min soo wife sexual dysfunction drug reactions, and the discontinuation of such drugs does not always result in the recovery of EF. Although hypertension and psychiatric disorders should be treated prior to ED management, this potential adverse reaction, which might be irreversible, should be discussed before prescribing such medications.

The diagnosis and clinical evaluation of ED Park min soo wife sexual dysfunction be helpful in the determination of personalized treatment options by identifying the underlying causes via the investigation of risk factors and by determining the severity of ED. A thorough history-taking is essential for all patients who suffer from ED. In addition, a physical examination and laboratory tests should also be conducted.

It is important to thoroughly review the previous Park min soo wife sexual dysfunction history of patients and their partners. Ideally, information on sexual behaviors should also be obtained by interviewing sex partners, even though this may not be possible in reality.

An interview with patients should be performed in an independent place with sufficient time and a comfortable environment to maintain the patient's privacy.

The presence of any risk factors related to ED should be determined. It is useful to explain concurrent risk factors to patients in advance to help the patient's understanding. The status of sexual behaviors before and after Park min soo wife sexual dysfunction should be investigated. ED should be investigated whether it is transient or persistent, whether it is acute or chronic, and if it is accompanied by other sexual dysfunctions ejaculation disorder, decreased sexual desire, and orgasm disorder.

In addition, treatment methods previously conducted and their efficacy should also be reviewed. The clinician should also inquire about erectile rigidity, erectile maintenance time, and the presence of nocturnal penile Park min soo wife sexual dysfunction. The sex-related diseases or menopause of partners should also be noted.

It is necessary to determine the presence of any risk factors of cardiovascular diseases, as well as concurrent diseases, such as hypertension, diabetes, and dyslipidemia. Any history of injury, surgery, or radiation therapy should be reviewed. The patient should also be checked for concurrent voiding dysfunction or Park min soo wife sexual dysfunction disorder, along with smoking history, drinking history, and previous and current medications.

The type, frequency, Park min soo wife sexual dysfunction, and intensity of current exercise are also checked. The IIEF has been used since after its Park min soo wife sexual dysfunction version was validated for its reliability and sensitivity. EF, orgasm, sexual desire, intercourse satisfaction, and overall sexual satisfaction. It is difficult to use it in actual clinical practice Park min soo wife sexual dysfunction it is too long.

A focused physical examination must be performed on every patient, with particular emphasis on the genitourinary, endocrine, vascular, and neurologic systems. Height, weight, BMI, blood pressure, heart rate, and waist circumference should be measured. It is recommended that laboratory tests be conducted selectively according to the symptoms and identified risk factors. The fasting glucose level, lipid profile, and testosterone levels should, however, be measured in all patients.

The testosterone level should be measured between 7 and 11 a. If hypogonadism is suspected during the disease history taking and physical examination, hormone tests for prolactin, luteinizing hormone LHand follicular stimulating hormone FSHshould also be conducted. It has been well known that the prevalence of cardiovascular diseases is high in patients with ED, and that Park min soo wife sexual dysfunction disease and ED have common risk factors.

According to the recommendation of the Princeton Consensus Panel, patients with ED should be classified into three groups according to the risk of heart disease, and then a proper treatment plan for each patient should be set up to predict the risks that might occur during sexual activities. Patients with ED should be classified into low-risk, intermediate-risk, and Park min soo wife sexual dysfunction groups, according to their cardiovascular status Table 1.

ORIGINAL RESEARCH—EPIDEMIOLOGY: Sexual Activity, Prevalence...

Three cardiovascular risk categories can be used as the basis for a treatment algorithm for initiating or resuming sexual activity. Risk factors for CAD: New York Heart Association. The cardiovascular system of the low-risk group is rarely influenced by sexual activities. Thus, the low-risk group does not require any additional examinations of the cardiovascular system. This group can have sexual activities without any particular examination and undergo treatment for ED.

As the risk of cardiovascular diseases is uncertain in the intermediate-risk group, a preliminary test is required before engaging in sexual activities.

This group may be reclassified into low and high-risk groups, depending on the result of the test. An exercise treadmill test is useful for this group. The high-risk group is in an unstable and serious cardiac status. Thus, sexual activities may increase the risk of heart disease. The high-risk group should be examined by Park min soo wife sexual dysfunction cardiologist, and a treatment for the heart should be conducted in advance. Sexual activities are not recommended Park min soo wife sexual dysfunction the cardiac status becomes stabilized after treatment or the safety of sexual activities is confirmed by a cardiologist.

ED can be managed in most patients after they undergo basic tests. However, some patients need specific diagnostic tests. For young men with a history of pelvic or perineal trauma, a specific test is required to check whether they could benefit from potentially curative vascular surgery.

Specific tests are also needed for patients with primary ED or with penile deformities that might require surgical correction, e. Other indications for specialized tests include patients with complex endocrine or psychiatric disorders Park min soo wife sexual dysfunction the request of the patient or his partner.

Specific tests may also be conducted for medicolegal Park min soo wife sexual dysfunction, such as a divorce suit or sexual abuse.

If neurogenic or psychogenic ED is suspected, the injection dose should be reduced due to the risk of priapism. Its main clinical implication is that patients will respond to the intracavernous injection program.

INTRODUCTION

Vasodilators are injected into the corpus cavernosum, and Park min soo wife sexual dysfunction the status of penile blood flow is measured using a Doppler spectrum analysis. The measurement of the peak systolic velocity PSV of the cavernosal artery and Park min soo wife sexual dysfunction end diastolic velocity EDVwhich indirectly reflects penile blood leak, is important.

The PSV is the most important evaluation factor. Internal pudendal arteriography should be selectively conducted Park min soo wife sexual dysfunction patients who have abnormal findings in penile duplex ultrasonography and who may be candidates for vascular reconstruction. An audiovisual sexual stimulation test can be conducted as a Park min soo wife sexual dysfunction test with relative ease, but its clinical usefulness is low as many factors can cause false negativity.

A neurologic test is mainly conducted for medicolegal purposes in order to investigate whether ED is associated with an accident Park min Park min soo wife sexual dysfunction wife sexual dysfunction surgery. An objective evaluation of autonomic cavernosal neurointegrity remains to be developed.

A bulbocavernosus reflex latency test and somatosensory evoked potentials test, which assess the somatic nervous system, are typically performed, but the reference value that determines normal and abnormal status has not yet been clearly established.

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The primary goal of ED treatment is to enable the satisfactory sexual activities of patients and their partners by recovering sufficient penile rigidity for sexual intercourse. Causes for ED, such as medication or lifestyle, are factors that can be addressed, and these factors should be corrected before or during the treatment of ED. Changes in lifestyle can not only improve ED, but also improve cardiovascular and metabolic diseases.

Psychogenic ED, arteriogenic ED caused by trauma in young patients, and ED caused by hormone abnormality can be cured via a specific treatment. However, as the treatments that are applied to most patients with ED are not performed based on specific causes for ED, patients should be informed of a variety of Park min soo wife sexual dysfunction modalities, and an appropriate treatment should be selected considering treatment efficacy, safety, invasiveness, cost, and the preference of the patient and partner.

As lifestyle changes and the modification of risk factors are effective methods for treating ED, patients should be educated about such changes along with any Park min soo wife sexual dysfunction treatment of ED, such as pharmacologic treatment. The potential advantages obtained by a change in lifestyle are particularly important in ED patients with specific cardiovascular or endocrine diseases, Park min soo wife sexual dysfunction as hypertension or diabetes.

Patients should be diagnosed with hypogonadism if they have clinical symptoms and biochemical evidence related to testosterone deficiency, such as decreased sexual desire and a low serum testosterone level. If patients with ED have hypogonadism, they are indicated for testosterone replacement treatment. As the serum testosterone level has diurnal variation, it should be measured from a blood sample collected between 7 and 11 a. In a meta-analysis of 17 randomized studies that were conducted on ED patients to investigate the effect of testosterone replacement treatment, the result showed that EF was Park min soo wife sexual dysfunction improved by testosterone replacement when the testosterone level before treatment was lower.

Thus, it should be kept in mind that the effect of testosterone replacement treatment is relatively less in elderly patients than in young patients. Both hyperthyroidism Park min soo wife sexual dysfunction hypothyroidism may cause decreased sexual desire Park min soo wife sexual dysfunction ED. Ejaculation disorder is known to be more frequently observed in hyperthyroidism and hypothyroidism. Hyperprolactinemia may cause ED, decreased sexual desire, and anorgasmia.

An increase in the blood prolactin level commonly accompanies the deficiency in testosterone by inhibiting LH secretion. Prolactin measurement is recommended in men with decreased sexual desire.

Park min soo wife sexual dysfunction is mainly caused by stress, drugs such as potent sedatives, and chronic renal failure. However, the possibility of the prolactin-secreting pituitary gland tumor also exists, even though it is very rare. In the case of persistent hyperprolactinemia for unknown reasons, patients should be referred to the department of endocrinology. If arteriogenic ED Park min soo wife sexual dysfunction in young patients after pelvic or perineal injury, arterial reconstruction surgery can be conducted when the focal narrowing is observed by penile duplex ultrasonography Park min soo wife sexual dysfunction selective penile arteriography, and when the veno-occlusive function is normal in DICC.

These patients should have no other arterial or neurological risk factors. It is recommended that ED patients and their partners receive education and a consultation during the pharmacologic treatment of ED.

ORIGINAL RESEARCH—EPIDEMIOLOGY: Sexual Activity, Prevalence...
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