Viagra (Sildenafil Citrate)

The use of Viagra and any nitrate medicine or recreational drug containing nitrates, at any time, is contraindicated. However, for certain patients, the drug can be used to successfully treat impotence.

Viagra offers patients convenient dosing. The initial recommended starting dose is 50mg; however, patients can be safely titrated up to 100 mg for increased success or decreased to 25 mg. Patients should not exceed 1 dose per day with a maximum dose of 100 mg.

Viagra works in as fast as 30 minutes, and remains active for up to 4 hours, allowing patients time for spontaneity and intimacy. The drug works with the body's response system, so patients should know that they will only see the effect if they are sexually stimulated. High-fat meals consumed before dose administration may slow down the effects of Viagra, and it is recommended that patients keep their physicians informed about their results. Best results may occur after the second or third attempt and some patients may have positive results with an increased dosage of 100mg.

Prostate Enlargement and Blockage (Benign Prostatic Hyperplasia) - Treatment for difficulty with urination or incomplete bladder emptying due to BPH is available with Indigo Laser to reduce blockage tissue as an outpatient procedure or office-based TUNA procedure. Dr. Bilowus is highly trained and experienced with the Indigo Laser and TUNA System.

Prostate Cancer Screening - Prostate physical exam (DRE) should be done in all men after age 40. In men with a family history, no knowledge of family history (adopted), or African-American heritage, PSA blood testing should begin at age 40 annually instead of age 50.

Kidney Stone Lithotripsy (ESWL) - This can now be performed effectively and quickly on stones within the ureter non-invasively (without surgery) with the new Reston Hospital Center Dornier Lithotriptor. Dr. Bilowus is specially trained and very experienced with the Dornier Lithotriptor.

Vasectomy - This procedure is available as an outpatient through the hospital or as a confidential, in-office procedure under local anesthetic. Special financial arrangements are available for patients not covered by insurance.

Vasectomy Reversal (Vasovasostomy) - This procedure can now be done with IV sedation and local anesthetics, using an operating microscope with 10x magnification.