With respect to neurological causes, involvement of any nerve group, either central or peripheral, may lead to erectile dysfunction. Cerebral diseases lead to decreased sexual interest, possibly through over-inhibition of spinal centres. Among patients with spinal cord injury, 95% of those who have upper motor neuron lesions are capable of reflexogenic erections, 25% of patients who have lower motor neuron lesions are capable of psychogenic erections, and more than 90% of patients who have incomplete lesions of either kind retain their erectile function.21 Direct injury to the cavernosal nerve and blood supply commonly occurs during therapy for prostate cancer; erectile dysfunction is present to some extent in 80% of patients so treated, whether by surgery or external beam radiation therapy.22 buy cialis canada rx online cialis Purchase viagra online Get cialis online "Animal studies have already indicated that you may be able to achieve as much or more with a single dose of radiation than with a protracted course," Scardino noted. "So, the big question is, are you going to find more complications as a result of this kind of a shift in dosage? Now, cutting back from seven and a half weeks to five weeks is a slight move in this direction, but they found no difference in sexual side effects, and that's valuable. And I certainly think we'll be seeing a lot more research in this area." Transurethral alprostadil provides the same significant improvement in erectile function as injectable alprostadil with a better tolerated method of delivery. In one large study,15 65 percent of patients reported successful and satisfactory intercourse. This form of alprostadil is thought to diffuse into the corpus spongiosum and then into the corpus cavernosum. Once the drug enters the cavernosum, the arteriolar smooth muscle relaxes, resulting in erection. In a large double-blind, placebo-controlled study, the most common reported side effect was penile pain (10.8 percent), which was not judged by patients to prevent its use.15 Much of the time
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