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For men who do not respond to oral medications, second-line treatments include vacuum erection devices, intracavernosal injections (alprostadil), intraurethral therapy, or penile prosthesis surgery

doi: 10.1016/0005-2760(82)90150-3 41 SeilerASchneiderMFrsterHRothSWirthEKCulmseeCet al

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