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Understanding High Blood Pressure and its Treatment OptionsHigh blood pressure, also known as hypertension, is a common health condition that can have several adverse impacts on an individual's health, including sexual function. Various medications are prescribed to manage this condition, including antihypertensive drugs. Introduction to Antihypertensive Medications: ACE inhibitors, alpha-blockers, ARBs, calcium channel blockers, beta-blockers, and diureticsThere are several categories of antihypertensive medications, including ACE inhibitors, alpha-blockers, ARBs, calcium channel blockers, beta-blockers, and diuretics. Each of these classes works in a different way to lower blood pressure, and they may have different side effects. Overview of Amlodipine: A Calcium Channel BlockerAmlodipine, a calcium channel blocker, is a frequently prescribed medication for managing high blood pressure. It helps to relax and widen blood vessels, allowing blood to flow more easily, which in turn reduces the pressure within the blood vessels. The Connection Between Antihypertensive Medications and Erectile DysfunctionCertain types of blood pressure medications, notably beta-blockers and diuretics, have been linked with erectile dysfunction. This sexual disorder can be a side effect of these medications. However, not all antihypertensive medications bear this risk. The Potential Impact of Amlodipine on Erectile DysfunctionThe relationship between amlodipine and erectile dysfunction is a subject of ongoing research. A 2007 study indicated that calcium channel blockers such as amlodipine could potentially increase the risk of erectile dysfunction in hypertensive patients. Despite this, amlodipine is not generally associated with causing erectile dysfunction. It is important to note that individual responses to medications can vary, and a small number of patients might experience this side effect. A Closer Look at the Research: Amlodipine and Erectile DysfunctionWhile some researchers propose a connection between amlodipine and erectile dysfunction, the majority of studies do not support this claim. Even in cases where erectile dysfunction does occur in patients taking amlodipine, these issues are often tolerable and cease without requiring the patient to stop taking the medication. Comparing Amlodipine with Other Antihypertensive Medications in terms of Erectile Dysfunction RiskWhen comparing amlodipine with other antihypertensive medications, it appears to have a lower association with erectile dysfunction. Drugs like beta-blockers and diuretics, particularly thiazide diuretics, have been more strongly linked with erectile dysfunction. On the other hand, lisinopril, a type of ACE inhibitor often used to treat high blood pressure, does not commonly cause erectile dysfunction. Lifestyle Interventions for High Blood Pressure: Diet and ExerciseIn addition to medication, lifestyle modifications such as diet and exercise are vital in managing high blood pressure. These non-pharmacological interventions can also contribute to improved sexual health and lower the risk of erectile dysfunction. Managing Erectile Dysfunction Issues: Tolerability and Medication WithdrawalIf a patient experiences erectile dysfunction while on antihypertensive medication, it's important to have a dialogue with the healthcare provider. Many times, these issues can be managed without discontinuing the medication. If amlodipine does cause erectile issues, they are usually tolerable and cease without requiring withdrawal from the medication. Conclusions: Can Amlodipine Cause Erectile Dysfunction?
However, individual responses may vary, and patients should always | ||||||||
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How does it work?Although we had in TURP a very good and tested operation, there are side effects and costs associated with it. This led to many minimally invasive approaches over the last decade. Sadly most of these were abandoned due to or a high risk of pain or other side effects compared to TURP, or because they simply did not work! Previous Attempts with LasersMany laser energies have been used in the prostate before now, but limitations on laser power have meant removal of significant amounts of prostate tissue (the real test) has been impossible or unfeasibly slow. The only two contenders for the TURP crown up until now have been prostate electrovaporisation (easy to learn but higher risk of infection, impotence and incontinence) and holmium laser prostate enucleation (as effective as TURP but extremely difficult to learn and associated with severe operative complications in all but the most expert hands). The Greenlight HPS system from AMS addresses this problem by means of delivering a very powerful modulated laser beam which is absorbed by the haemoglobin pigment in tissue. This means that when the laser is applied to prostate tissue massive localised heating of the tissue occurs resulting in instantaneous vaporisation: due to the laser - characteristically bleeding is close to zero. Our results show that prostates of any size can be treated, with most men seeing their symptoms improve by two or three fold in the first six weeks. Many men have continuing benefits developing up to nine months after surgery The technique allowsrapid creation of a generous prostate cavity with almost no bleeding. More than 50% of men can leave hospital on the day of surgery without a catheter, with most others having a soft small catheter for around 18 hours at home (many men remove this themselves)Althoughwe placed catheters post operatively in our initial evaluation period, only a few men have had to have a catheter for more than 12 hours (these have usually been in urinary retention patients, and nearly all have voided extremely well on final catheter removal. Strikingly, very few patients report pain after the procedure: pain and burning on urinating have limited both laser techniques and TURP in the past. About one man in ten will get some burning which may need a fe weeks of simple painkillers to ease the discomfort. Sexual side effects are reduced compared to the standard technique. While very long term results are awaited, the figures after five years of follow up show improvements in symptoms and urological measurements comparable to historical TURP data (about one man in fifty requiring reintervention each year). In particular it appears the prostate tissue removal seen at the time of surgery is genuine when assessed by post-operative prostate ultrasound (between 40-60% of tissue reduction is seen). Post operative bleeding and discomfort can occur, but aremuch less than with standard TURP, and many men have gone back to work or normal activities within a couple of days, with sport and other activities being possible within a week or two. Of course, some men do take longer to recover and those men with very overactive bladders or catheters pre-operatlively may take some time to settle afterwards. Anticoagulation, large prostate size (>100g) and poor cardiac status are not contraindications to the procedure, even as a day case. Our results have been presented at a number of international meetings including the European Association of Urology and the American Urological Association Meeting. In particular our data on large prostates and the absence of absorption of irrigating fluid has attracted much interest. Mr Muir isa founder member of the International GreenLIght Users' Group, which seeks to fine tune and improve further the results from this therapy. IPSS Symptom scores changes following PVP to one year
The initial score of 23 on the IPSS system shows that most men were suffering severe symptoms which reduced by almost threefold within sixweeks. Urine flow rates at the same stage and out to five years in our series showimprovements of more than 100%.
GreenLight Training Courses at King's College Hospital (for urological surgeons wishing to learn the technique)
Course director: Gordon Muir, Consultant Urologist The course will be in the format of small group teaching with a mixture of didactic presentations linked to live 2 way videoconferencing observing a number of prostate vaporisations in the operating theatre downstairs from our conference room.. There will be an opportunity to visit our state of the art integrated operating theatres during procedures to observe the set-up and logistical issues relating to prostate laser surgery. The objectives of the course will be that at the end of the course participants will be able to:
Topics covered in the course include: GreenLight PVP results Previous lasers: problems and successes Why green light? Laser physics and safety Live cases Theatre and nursing issues Discussion: how to startup, avoiding complications
Certificates of GreenLight laser training and CME credits will be awarded to those who have successfully completed the training course. CME accreditation has been applied for. Refreshments and lunch are included in the course fee Course dates at King's College Hospital 6th April 2009 11th May 2009 8th June 2009 6th July 2009
Training video (NB this is NOT a substitute for attending a properly run course and having mentoring for the surgical technique) for further information on courses contact [email protected]
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GreenLight Training Courses
We are able to offer formal training courses for doctors interested in knowing about the GreenLight procedure. Formal half day courses are run in the Day Surgery Teaching UNit at KIng's College Hospital.
Course director: Gordon Muir, Consultant Urologist
The course will be in the format of small group (max 10) teaching with a mixture of didactic presentations linked to live 2 way videoconferencing observing a number of prostate vaporisations in the operating theatre downstairs from our conference room.. There will be an opportunity to visit the operating theatres during procedures to observe the set-up and logistical issues relating to prostate laser surgery.
The objectives of the course will be that at the end of the course participants will be able to:
Topics covered in the course include:
Certificates of GreenLight laser training and CME credits will be awarded to those who have successfully completed the training course
CME accreditation has been applied for.
Refreshments and lunch are included in the course fee