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  #31  
Old 08-02-2019, 06:43 AM
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Re: shockwave therapy for ED

Those of you who are patients of Dr Tan can ask him about the drug. It is definitely available in Singapore as it is used often in medical and dental practices.

With a doctor's prescription, the pharmacies should be able to formulate the required dosage in the form of a tablet or lozenge to be taken orally 30 minutes before sex.

For those who suffer from nerves this drug should solve your problem. Try it. You have nothing to lose. It can also be formulated to be combined with an ED drug like Viagra or Cialis for double the effect.

Once you have regained your confidence you probably won't need it anymore. Just keep it in your pocket as an insurance policy in case things are not happening. Very often the fact that you know you have the option to use it will give you enough confidence not to need it in the first place.
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  #32  
Old 08-02-2019, 06:46 AM
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Re: shockwave therapy for ED

This whole study cost me a lot of money!

Shockwave therapy was $600 per session x 6 = $3600

P shot was $1950.

Phentalomine experiment cost $200.

Any donations to offset the costs would be most welcome.
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  #33  
Old 08-02-2019, 07:19 AM
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Re: shockwave therapy for ED

wah.. many thanks for the huge update boss. was waiting for your update.

not sure if i can afford the whole treatment at one go, maybe i will have to do it step by step or have to look for alternative.


Quote:
Originally Posted by sammyboyfor View Post
This whole study cost me a lot of money!

Shockwave therapy was $600 per session x 6 = $3600

P shot was $1950.

Phentalomine experiment cost $200.

Any donations to offset the costs would be most welcome.
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  #34  
Old 08-02-2019, 08:50 AM
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Re: shockwave therapy for ED

Quote:
Originally Posted by 5 STAR GENERAL View Post
wah.. many thanks for the huge update boss. was waiting for your update.

not sure if i can afford the whole treatment at one go, maybe i will have to do it step by step or have to look for alternative.
Why don't you try the phentalomine pills to start off with. If your performance could well be inhibited simply because you don't feel confident. It may have no physical basis whatsoever.
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  #35  
Old 08-02-2019, 10:24 AM
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Re: shockwave therapy for ED

https://www.jurology.com/doi/full/10...2801%2963559-6

ORAL PHENTOLAMINE AS TREATMENT FOR ERECTILE DYSFUNCTION
ARMIN J. BECKER
,
CHRISTIAN G. STIEF
,
STEPHAN MACHTENS
,
DIRK SCHULTHEISS
,
UWE HARTMANN
,
MICHAEL C. TRUSS
, and
UDO JONAS
https://doi.org/10.1016/S0022-5347(01)63559-6
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Abstract
Purpose:
For most patients with erectile dysfunction oral agents are a preferred treatment option. Oral or buccal phentolamine has been shown to produce full erections in impotent subsets of study populations. We evaluate the efficacy of oral phentolamine.

Materials and Methods:
After a comprehensive evaluation 44 patients with recent onset (less than 3 years) of erectile dysfunction and a high likelihood of organogenic etiology underwent a prospective, double-blind and placebo controlled trial with oral phentolamine after placebo.

Results:
After placebo 4 of the 44 patients who reported full erections were excluded from study. Of the 40 patients in the double-blind phase full erections were achieved by 2 of 10 with placebo, and 3 of 10 with 20 mg., 5 of 10 with 40 mg. and 4 of 10 with 60 mg. phentolamine. There were no serious complications observed during the study, and only a single minor side effect occurred in 1 patient after 60 mg. phentolamine.

Conclusions:
Our results indicate that oral phentolamine may be of benefit for the treatment of erectile dysfunction. Further studies are required to corroborate our findings.

Key Words: penile erection, phentolamine

For most patients with organogenic erectile dysfunction intracavernous pharmacotherapy, [1-6] penile prosthesis implantation [7] and application of a vacuum device [8] represent reliable therapeutic options. However, many patients refuse these therapies due to various reasons, such as loss of spontaneity, side effects or the nonphysiological nature of the treatment itself. [5,6] Furthermore, long-term observations show a significant dropout rate or a significant percentage of dissatisfied patients who chose the aforementioned options. [5,6] Due to the underlying etiology, only a limited number of patients can be offered reconstructive surgery, such as arterial revascularization or penile venous surgery, which allow spontaneous erections. [9-12]

For most patients with erectile dysfunction an oral drug is preferred. In addition to the widespread use of yohimbine [13] and the recent promising results with the sildenafil [14] and apomorphine [15] trials, the alpha-blocking agent phentolamine has been evaluated as a possible treatment option. Zorgniotti noted a 42% rate of full spontaneous erections with 50 mg. phentolamine in patients with erectile dysfunction, [16] and a similar response rate was reported by Gwinup. [17] We examine in a double-blind, placebo controlled, prospective trial the effects and side effects of 20, 40 and 60 mg. phentolamine in patients with erectile dysfunction.

MATERIALS AND METHODS
All patients at our impotence clinic undergo a comprehensive evaluation regarding the etiology of erectile dysfunction, including family history, physical examination, blood laboratory studies (testosterone), sexual history by a psychiatrist, [18] corpus cavernosum electromyography, [19] pharmacological testing using prostaglandin E1 [6] and Doppler or color coded duplex sonography of the penile arteries. When indicated, patients undergo cavernosometry and cavernosography, penile angiography or somatomotor and/or autonomic neurological examination. Phentolamine, 20, 40 and 60 mg., was prepared in fast dissolving tablets. These preparations showed blood levels that peaked approximately 30 minutes after administration and were considered to be sufficiently high (greater than 10 ng./ml.) for about 2 hours.

Inclusion criteria for the study were a history of erectile dysfunction for less than 3 years, no significant cardiovascular disease, no diabetes or neurological diseases, tolerance to the study medication (tested after the placebo phase applying the study medication in the office for 2 hours) and a stable partnership. Since all patients had undergone the aforementioned comprehensive evaluation we were able to exclude those with a pure or predominant severe psychogenic etiology of disease. [18]

Patients entering the study were given an in office test dose to evaluate ability to tolerate the drug. During the test dose period patient's blood pressure and pulse were checked every 2 hours with patients standing and supine. After a single blinded placebo phase and 3 erectile attempts, patients with 1 or more successful attempts were excluded from the study phase. A successful attempt was defined as vaginal penetration. Then, 3 doses of either placebo, or 20, 40 or 60 mg. tablets were dispensed, and patients were instructed to attempt intercourse on 3 occasions. Patients were requested to complete detailed diaries on the effect and side effect of the medications. The study was approved by the University's Ethical Committee and run according to Food and Drug Administration standards.

RESULTS
Of 44 patients who met the inclusion/exclusion criteria of the study 4 (9%) reported 1 or more successful erectile attempts during the placebo phase and, thus, were excluded from the study. In the double-blind phase to receive placebo, or 20 mg., 40 mg. and 60 mg. phentolamine 10 patients each were randomized. Full erection was achieved after placebo by 2 patients, and after 20 mg. by 3, after 40 mg. by 5 and after 60 mg. phentolamine by 4. When all attempts were analyzed placebo (30 attempts) yielded a 13.4% success rate compared to 20, 40 and 60 mg. phentolamine (each group 30) with success rates of 20.0%, 30.0% and 36.7%, respectively.

Mean age was 48 years (range 26 to 70) of the responders and 52.2 years (range 27 to 69) of the nonresponders to phentolamine. Mean age of the responders to 20, 40 and 60 mg. phentolamine was 46, 51.8 and 45 years, respectively, and of the nonresponders it was 50.6, 50.6 and 55.3 years, respectively. Mean age was 39 years responders, 45.1 years of the nonresponders to placebo.

In regard to the diagnostic evaluation neither case history, status of the penile arteries or response to pharmacological testing showed any obvious correlation (the groups were not large enough for statistical analysis with biological relevance) to response or nonresponse to phentolamine or placebo. Corpus cavernosum electromyography showed a positive predictive value only for patients receiving 60 mg. phentolamine. Of patients with a normal corpus cavernosum electromyography had intercourse after phentolamine and 5 of 6 with an abnormal corpus cavernosum electromyography had no effect after phentolamine. The only side effect reported was a stuffy nose after the study medication of 60 mg. phentolamine in 1 patient.

DISCUSSION
Our prospective, randomized, double-blind study revealed a beneficial effect of orally administered fast desolving phentolamine on the erectile capacity of men with erectile dysfunction. Although our patient data base is too small for relevant statistical analyses, we believe that our data show a biologically trend. This assumption is further supported by the response or nonresponse to the 60 mg. dose. Of 4 patients with presumably normal cavernous tissue an intact autonomic supply (normal corpus cavernosum electromyography) 3 responded to 60 mg., whereas 5 of 6 with either defective cavernous tissue or/and defective cavernous autonomic supply (abnormal corpus cavernosum electromyography) did not respond. Thus, phentolamine appears to induce beneficial effects in patients with erectile dysfunction of mild organogenic, psychogenic (stress or performance anxiety) or mixed psychogenic-organogenic etiology. In patients with pronounced organogenic defects an orally active drug should not be expected to have a significant effect on the erectile capacity.

The main inclusion criteria of the study were strict. Patients achieving vaginal penetration, even with difficulties, were excluded from study. In routine practice many patients complaining of erectile dysfunction are still able to penetrate, but they are not able to maintain rigidity. Since these patients are unable to complete intercourse, they evidently suffer from erectile failure. Furthermore, we think that those patients still experiencing some erectile capacity would be better studied for such a therapeutic option than those with a more severe grade of erectile dysfunction.

We would suggest an erection that enables subjectively satisfying intercourse as the end point for subsequent other studies evaluating therapeutic options for erectile dysfunction. Although the grade of erection obviously varies among patients using this end point, this is the therapeutic goal of patients and, consequently, should be the goal of physicians. In a previous, multicenter study of the evaluation of penile arterialization this end point was chosen since it most accurately met the treatment objective. [20]

Currently, there are many ongoing clinical studies evaluating the possible efficacy and side effects of new and promising oral agents to restore erectile function, including a study on the centrally acting apomorphin. [18] A success rate of approximately 70% with apomorphin was observed in a pilot trial compared to a placebo response rate of about 40%. Similar data were generated in the trials using mechanisms to inhibit selectively a phosphodiesterase isoenzyme. [21] Since these studies were done in patients with predominantly psychogenic etiology (not further specified), their results cannot be compared to ours because our data were mostly derived from patients with significant organogenic factors.

CONCLUSIONS
Our prospective, randomized, double-blind study revealed a beneficial effect of orally administered fast desolving phentolamine on the erectile capacity of men with erectile dysfunction. Although our patient numbers as to small for relevant statistical analyses, we believe that our data indicate a biologically obvious trend that warrants further extended studies.

Zonagen USA provided drugs and financial support for this study.
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  #36  
Old 09-02-2019, 09:14 AM
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Re: shockwave therapy for ED

have been googling and until now i still cannot find a clinic that does P shot in singapore.
anyone knows?
  #37  
Old 09-02-2019, 09:59 AM
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Re: shockwave therapy for ED

Quote:
Originally Posted by hellobye View Post
have been googling and until now i still cannot find a clinic that does P shot in singapore.
anyone knows?
The homepage of the p shot at www.priapusshot.com

Lists this place https://www.fusionmedical.com.sg/

However one of the brothers there called up and they claimed that they do not do the procedure so it is a strange situation.

Perhaps you can enquire further and find out why they are listed in the first place.
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  #38  
Old 09-02-2019, 10:34 AM
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Quote:
Originally Posted by sammyboyfor View Post
The homepage of the p shot at www.priapusshot.com

Lists this place https://www.fusionmedical.com.sg/

However one of the brothers there called up and they claimed that they do not do the procedure so it is a strange situation.

Perhaps you can enquire further and find out why they are listed in the first place.
yeah that brother is me. i email them asking about it but they said they dont do it. i told them that their clinic is listed on that website and then they didnt reply anymore.
  #39  
Old 09-02-2019, 10:44 AM
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Re: shockwave therapy for ED

Quote:
Originally Posted by hellobye View Post
yeah that brother is me. i email them asking about it but they said they dont do it. i told them that their clinic is listed on that website and then they didnt reply anymore.
Very strange and I'm afraid I don't have an answer.
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  #40  
Old 09-02-2019, 11:08 AM
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Originally Posted by sammyboyfor View Post
Very strange and I'm afraid I don't have an answer.
anyway i have checked with a doctor and
unfortunately, platelet rich plasma are not allowed to be done at GP center in Singapore, that explains why no clinic does that in SG
  #41  
Old 09-02-2019, 01:00 PM
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Re: shockwave therapy for ED

Yoz big boss,

Few months ago u wrote "3 weeks on it my erections are definitely firmer not quite up to what can be achieved with Cialis but pretty close."

If that is the case, may i ask then why dun u just stick with Cialis in the first place ah? Cheaper better and also no side effects right?

Sorry ah, i very noob in this...
  #42  
Old 09-02-2019, 01:58 PM
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Re: shockwave therapy for ED

Cialis isnt a perm solution....shockwave therapy could be
but of course i am not sam.. so i dont really know why..


Quote:
Originally Posted by Loser--- View Post
Yoz big boss,

Few months ago u wrote "3 weeks on it my erections are definitely firmer not quite up to what can be achieved with Cialis but pretty close."

If that is the case, may i ask then why dun u just stick with Cialis in the first place ah? Cheaper better and also no side effects right?

Sorry ah, i very noob in this...
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  #43  
Old 09-02-2019, 02:58 PM
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Re: shockwave therapy for ED

Quote:
Originally Posted by Loser--- View Post
Yoz big boss,

Few months ago u wrote "3 weeks on it my erections are definitely firmer not quite up to what can be achieved with Cialis but pretty close."

If that is the case, may i ask then why dun u just stick with Cialis in the first place ah? Cheaper better and also no side effects right?

Sorry ah, i very noob in this...
I don't like taking drugs. There is always a question mark as to what they will do to your body over the long term.

I embarked upon this exercise as a form of investigative journalism to find out whether all these alternative treatments make any difference. Before that I have never used any ED pills. Everything still works so I'm happy as I am and count my blessings.
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  #44  
Old 09-02-2019, 07:44 PM
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Re: shockwave therapy for ED

Yes, true. If i am not wrong, viagra/cialis have been around for only the last 30 years. There have been inconclusive studies on what kind of long term side effects on one's body if it were to be consumed regularly
  #45  
Old 10-02-2019, 12:54 PM
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Re: shockwave therapy for ED

https://www.peaktestosterone.com/Ere...ntolamine.aspx

Erectile Dysfunction and Phentolamine (Vasoviril)
GUEST AUTHOR: Inigo

Oral Phentolamine is another alpha-blocker which, unlike doxazosin, is marketed specifically as a treatment for erectile dysfunction and is, like Viagra, taken on demand . The trade name is Vasoviril. It has not been granted a licence in Europe or North America, but is approved in Brazil and Mexico.

CAUTION: All the alpha blockers should only be used under a doctor's supervision, because they 1) interact very negatively with certain medications, 2) can have very serious side effects and 3) can cause priapism, an erection that does not go away and can damage the penis permanently. See my link on Common Causes of Priapism for more information on the latter. If you ever have an erection that will no go away after an hour or two, go to the E.R. Your sex life is at stake.

Phentolamine is a non-selective alpha-adrenergic blocker and thus is in the same general class as the well-known herb herbal erectile dysfunction remedy yohimbine. The alpha-adrenergic receptors are used by noradrenaline and noradrenaline to put the brakes on erections.


NOTE: You can find out more information about another alpha blocker by going to my page on Doxazosin and Erectile Dysfunction.

My experience on the Peak Testosterone Forum is that alpha blockers are rarely used to treat erectile dysfunction. However, some of the study work indicates that they can be very effective in many men. For example, a German trial in 1998 reported that phentolamine helped 50% of men. And there are other reports it works synergistically with PDE5i.

A paper in 2001 from the Boston School of Medicine reviewed data on Vasomax (now Vasoviril) and stated that two large scale trials have found that Vasomax was associated with significant increases in the IIEF-EF scale. However these trials were conducted when Viagra was being developed and many men on the trials left to join the Viagra testing. And Viagra is generally regarded as more successful.

A 2002 Californian study reported that

"the objectives of this study were to evaluate long-term safety and efficacy of phentolamine mesylate, an orally active, rapid-acting alpha-adrenergic receptor antagonist, for the treatment of erectile dysfunction. It was an open-label study involving more than 2000 patients. Men received phentolamine mesylate 40 mg or 80 mg (10 tablets/month) as needed for up to 13 months and self-assessed erectile performance using two validated questionnaires. Treatment with phentolamine mesylate was associated with increases in Erectile Function Domain score of the IIEF, successful vaginal penetrations, and in overall satisfaction. Most adverse events were mild or moderate in severity and consistent with the known pharmacodynamic properties of phentolamine. In conclusion, phentolamine mesylate is safe and effective in the long-term treatment of men with mild to moderate ED."

An August 2002 report in the International Journal of Impotence Research stated that, averaging two American trials, the mean change scores in the EF domain from baseline to the end of treatment in the parallel-design study were -2.3, 5.7 and 6.7 for the placebo, 40 mg, and 80 mg groups, respectively. So a healthy increase of 8 or 9 over a placebo. (The two trials were 28 Goldstein I, Carson C, Rosen R, Islam A. Vasomax for the treatment of male erectile dysfunction ; and Goldstein I. Oral phentolamine: an Alpha-1, Alpha-2 adrenergic antagonist for the treatment of erectile dysfunction.)

Oral Phentolamine is faster acting and shorter lasting than Viagra, and should be taken on an empty stomach. Users suggest it takes effect in about half an hour and it lasts about two to four hours. They also suggest Phentolamine works very well in combination with PDE5i. The cost is about twice that of Viagra.
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