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Surgery to repair arteries (penile arterial reconstructive surgery) can reduce impotence caused by obstructions that block the flow of blood to the penis. The best candidates for such surgery are young men with discrete blockage of an artery because of a physical injury to the pubic area or a fracture of the pelvis. The procedure is less successful in older men with widespread blockage of arteries. viagra online risks buy viagra When there is angina or heart failure, the doctor may need to determine whether the heart has enough reserve to safely carry out the work necessary for sexual activity by performing cardiac treadmill stress testing. Erectile dysfunction can occur if one or more of these requirements are not met. The following are causes of erectile dysfunction: Erectile dysfunction (ED) is when a man has trouble getting or keeping an erection. ED becomes more common as you get older. But male sexual dysfunction is not a natural part of aging. Sildenafil is used for the treatment of erectile dysfunction of either physical or psychological cause. It has been found to be effective in treating erectile dysfunction in men with coronary artery disease, diabetes mellitus, hypertension, depression, coronary artery bypass surgery, and men who are taking antidepressants and several classes of anti-hypertensives. Call Your Doctor immediately or Go to an Emergency Room If: You have an extended or painful erection, unrelated to sexual desire, lasting more than a few hours. canadian online pharmacy viagra no prescription buy viagra online This section needs additional citations for verification. (May 2010) buy kamagra online usa kamagra online sale Viagra no perscription usa