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Top of page The case A 46-year-old male presented to our urology clinic 1 year after sustaining an injury to his perineum. He was otherwise healthy, with no underlying medical conditions and led a very active lifestyle. The patient reported no previous traumatic injuries and presented with no other risk factors for erectile dysfunction. The injury occurred when he fell from his surf board and inadvertently speared himself with it. He described having perineal pain immediately after the injury, which continued to the date of his office visit, although with reduced severity. He also described a significant amount of bruising in the area, which subsided over time. His main complaint was that he was only able to obtain a 50–65% erection based on self report. His SEXUAL HEALTH INDEX FOR MEN score was 20. He had sought treatment from several urologists over the previous year for his erectile dysfunction, and had undergone trials of sildenafil 200 mg and tadalafil 20 mg on several occasions without improvement. In the treated rabbits, tests showed that pressure inside the penis, a key component of an erection, was normal. Other tests showed that blood flow, response to nitric oxide, drainage of the blood after the erection and presence of sperm in the female vagina were also normal. The tissue engineering worked so well that four of 12 females were impregnated by the repaired rabbits, according to the study. Reality: The incidence of erectile dysfunction certainly increases with age, but it is in no way an inevitable part of the aging process. Changes in erections and in the amount of time it takes to achieve one are normal signs of aging and should not be confused with ED, which is the repeated inability to get or keep an erection firm enough for sexual intercourse. Lifestyle changes, such as quitting smoking, exercising regularly, avoiding excessive alcohol consumption, and carefully monitoring chronic illnesses, like kidney disease or diabetes, can help decrease your risk of developing ED. buy Viagra 50mg here buy viagra online without prescription I wish this website had been available to me, when I was looking for information about injections, says Al Orr, the man who created EDshot.com.