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Question
went to doctor he said it is performance anxiety and he advised me to use Viagra, i used Viagra but not work, the he referred me to urologist he checked my testosterone after blood test my testosterone level was normal. both doctors said i am medically fit so if i am normal and perfect that why i have erection problem why i can't maintain my erection?

Answer
Adnan:

Obviously I can't tell you why you have an ED problem from only the limited information presented.  The most common causes are extreme anxiety, prostate cancer, low testosterone, diabetes, high blood pressure and arteriosclerosis.  

One test to see if the underlying problem is anxiety related or physical is to do a Rigiscan or nocturnal penile tumescence monitoring test.  If this shows good nocturnal erections, then a psychological cause is suggested and usually Viagra works quite well for this.  

You may not have used the viagra correctly (on an empty stomach) or perhaps you didn't take the higher recommended dose of 100 mg.  Viagra often takes 4-5 tries before it kicks in so you may have given up too soon. See what your urologist recommends or get a second opinion.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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