Table of contents

• Understanding Erectile Dysfunction (ED)
• Advanced Medical Procedures for ED
• Best Clinics in Korea for Erectile Dysfunction Ailment
• Medical Tourism for ED Treatment in South Korea
• Costs and Value: South Korea vs. Global Destinations
• Conclusions
• References

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Erectile dysfunction (ED) is commonly described as the inability to achieve or maintain an erection firm enough for satisfactory sexual activity. Affecting millions of men worldwide, ED is often distressing but treatable. While sometimes called impotence, this term is less favored in medical contexts to avoid confusion. Studies show that over half of men aged 40 to 70 experience some form of ED, with rates rising sharply with age—about 17% of men in their 60s and 47% of men over 75 face total inability to achieve an erection. However, ED is not an inevitable part of aging and can be treated at any age. The main signs include persistent difficulty in getting or keeping an erection and reduced sexual desire. Occasional issues are normal, but ongoing problems can cause stress, lower self-confidence, and strain relationships.

This guide offers a thorough overview of erectile dysfunction, explores advanced treatments like stem cell therapy and penile implants, and highlights South Korea as a leading destination for medical tourism related to ED.

Understanding Erectile Dysfunction (ED)

Grasping how erections work and what can disrupt them is key to effectively addressing ED.

How Erections Occur and What Can Go Wrong

Erections result from a complex interaction between the brain, hormones, nerves, muscles, and blood vessels. Sexual arousal triggers nerve signals that increase blood flow into two sponge-like chambers in the penis called the corpora cavernosa. As these chambers fill, the penis expands and becomes rigid. The tunica albuginea, a surrounding membrane, traps blood inside the corpora cavernosa to maintain the erection. When muscles contract, blood flow decreases, and the penis returns to a flaccid state.

ED can occur if any part of this system malfunctions. Problems with the tunica albuginea, hormone imbalances, smooth muscle tissue, blood vessel lining, or penile arteries can all interfere with achieving or sustaining an erection.

Common Causes and Risk Factors

ED usually results from a mix of physical and psychological factors.

Physical Causes: Conditions like heart disease, high cholesterol, high blood pressure, diabetes, obesity, and smoking can impair blood flow to the penis, causing vascular ED. Nerve damage can lead to neurogenic ED, while low testosterone levels may reduce sexual desire and erection ability. ED can also signal broader health issues such as clogged arteries or diabetic nerve damage, making it important to view ED as a potential indicator of overall health.

Psychological Causes: Mental health issues like depression, anxiety (especially performance anxiety), chronic stress, and relationship problems can cause or worsen ED. Feelings of inadequacy, sexual fears, and past trauma also contribute. The stigma and embarrassment around ED often prevent men from seeking help, highlighting the need for supportive healthcare approaches that include psychological counseling and partner involvement.

Combined Causes: Often, ED stems from both physical and psychological factors. For example, a minor physical issue might trigger anxiety about sexual performance, which then worsens ED. This complexity requires thorough diagnosis and personalized treatment plans that may involve lifestyle changes, managing chronic diseases, and psychological support.

Risk Factors: While aging can affect erection quality and speed, ED is not a normal or unavoidable part of aging. Other factors usually play a role as men get older.

When to Seek Medical Advice

Many men hesitate to discuss ED due to embarrassment, but consulting a healthcare professional is crucial. A family doctor or internist is a good starting point. Medical advice is especially important if there are concerns about erections, other sexual problems like premature ejaculation, or underlying conditions such as diabetes or heart disease. Treating these conditions can often resolve ED. Without treatment, ED can lead to depression, anxiety, low self-esteem, relationship difficulties, and infertility.

Table 1: Common Causes and Risk Factors of Erectile Dysfunction

Category	Examples	Description
Physical Causes	Heart Disease, High Cholesterol, High Blood Pressure, Diabetes, Obesity, Smoking	Impaired blood flow, nerve damage, or hormonal imbalances affecting penile function.
	Clogged Arteries (Vascular ED)	Blockage or damage to blood vessels supplying the penis.
	Nerve Damage (Neurogenic ED)	Disruption of nerve signals from the brain to the penis.
	Low Testosterone (Hormonal ED)	Reduced sex drive and difficulty maintaining erections.
Psychological Causes	Depression, Anxiety (Performance Anxiety), Chronic Stress	Mental health conditions interfering with sexual arousal and response.
	Relationship Issues, Sexual Fears, Feelings of Inadequacy	Emotional and interpersonal factors contributing to erectile difficulties.
Lifestyle Factors	Poor Diet, Lack of Exercise, Excessive Alcohol Intake	Habits negatively impacting cardiovascular health and overall well-being, indirectly affecting erectile function.

Advanced Medical Procedures for ED

This section covers two advanced treatments: stem cell therapy and penile implants, explaining how they work, their types, and current scientific perspectives.

Stem Cell Treatments for Sexual Performance

Stem cell therapy is an exciting, emerging treatment aiming to fix the root causes of ED rather than just symptoms. Stem cells can self-renew and transform into different specialized cells.

What Are Stem Cells and How Do They Work for ED?

Mesenchymal Stem Cells (MSCs), the most studied type, may help ED through several mechanisms:

• Cellular Differentiation and Replacement: MSCs might transform into endothelial cells (lining blood vessels), smooth muscle cells (important for rigidity), Schwann cells, and neurons, potentially repairing damaged penile tissue.
• Paracrine Effect (Most Prominent Theory): MSCs release growth factors, cytokines, and exosomes that promote tissue repair, new blood vessel formation, and reduce scarring, all vital for erectile function.
• Neuromodulation: Adipose-Derived Stem Cells (ADSCs) may aid nerve regeneration, improving function after nerve injury.
• Anti-inflammatory and Anti-apoptotic Effects: MSCs can reduce inflammation and cell death, which are linked to ED risk factors like diabetes and obesity.

Sources of Stem Cells Used in ED Therapy

MSCs are favored for their safety and versatility, with common sources including:

• Adipose-Derived Stem Cells (ADSCs): Taken from the patient’s own fat tissue, reducing immune risks. Their benefits mainly come from secreted factors like VEGF and BDNF.
• Bone Marrow-Derived Stem Cells (BMSCs): Extracted from bone marrow, used in clinical trials especially for ED after prostate surgery or in diabetic patients.
• Other Emerging Sources: Placenta-Derived Stem Cells, Umbilical Cord Stem Cells, Urine-Derived Stem Cells, MSC-Derived Exosomes, and stem cells from oral mucosa or baby teeth pulp are under investigation.

Current Scientific Evidence and Consensus: A Critical Look

Although stem cell therapy shows promise and progress in early studies, there is currently insufficient evidence to recommend it as a standard ED treatment. Most urological societies agree that more research is needed to confirm benefits, establish protocols, and determine optimal cell types and doses.

Clinical data on humans is limited, with fewer than 100 patients reported across 27 trials, many of which are ongoing or unpublished. Public interest is growing, often driven by aggressive marketing that may overstate benefits without clear scientific backing. This creates ethical concerns, especially for medical tourists who may be vulnerable to unproven claims.

Patients should be cautious, understanding that stem cell therapy for ED remains experimental, with no standardized treatment or long-term safety data. Choosing reputable, accredited clinics is essential. Large, placebo-controlled trials with long follow-up are needed before widespread clinical use.

Penile Implants

Penile implants are surgically placed devices that help men with ED achieve erections when other treatments fail.

Types of Penile Implants: Inflatable vs. Semirigid

There are two main types:

• Inflatable Implants (Most Common):
  • Three-piece Inflatable: Two cylinders in the penis, a fluid reservoir in the abdomen, and a pump in the scrotum. Pumping moves fluid to inflate cylinders for an erection; a release valve deflates them. This offers the most natural feel and flaccidity when not in use but involves more mechanical parts and abdominal surgery.
  • Two-piece Inflatable: Similar but combines reservoir and pump in the scrotum, eliminating the abdominal reservoir. Provides partial flaccidity but less firmness than the three-piece.
• Semirigid Rods: Always firm rods implanted in the penis that can be bent up for sex and down for concealment. Simple design means low malfunction risk and ease of use, ideal for those with limited dexterity. However, constant rigidity can be hard to hide and may cause discomfort over time.

Implants are custom-sized, with options for different penis sizes. Some have antibiotic or friction-reducing coatings to lower infection risk and extend lifespan. The choice depends on patient health, preferences, and surgeon advice.

Table 2: Comparison of Penile Implant Types

Type of Penile Implant	Description	Pros	Cons
Three-piece Inflatable	Cylinders in penis, reservoir in abdomen, pump/valve in scrotum. Inflated for erection, deflated for flaccidity.	Most natural, rigid erection; flaccid when deflated.	More parts (higher malfunction risk); requires abdominal reservoir.
Two-piece Inflatable	Cylinders in penis, combined reservoir/pump in scrotum. Inflated for erection, deflated for partial flaccidity.	Partial flaccidity when deflated.	More complex mechanically; less firm than three-piece.
Semirigid Rods	Always firm rods; penis bent for sex or concealment.	Low malfunction risk; easy to use.	Constant rigidity (concealment issues); possible tissue pressure discomfort.

The Surgical Procedure: What to Expect

Pre-operative Preparation: Patients consult a urologist for medical history review, physical exam, and suitability assessment. The irreversible nature, benefits, risks, and complications are discussed, ideally with the partner present. Certain medications may be paused before surgery. Patients arrange transportation and fasting before the procedure.

During Surgery: Performed under general or spinal anesthesia in a hospital or surgery center. IV antibiotics and antiseptic prep reduce infection risk. The surgeon makes an incision (penile base, below the glans, or lower abdomen), stretches the corpora cavernosa, and implants the device sized to the patient. For three-piece implants, a fluid reservoir is placed in the abdomen. Surgery lasts about 45 minutes to an hour.

Potential Complications: Infection rates are low (1-3%, sometimes as low as 0.5% in experienced centers). Other risks include corporal crossover or perforation. Complication rates are higher in low-volume centers, so choosing experienced surgeons is critical for safety and success.

Post-operative Care: Pain medication and sometimes long-acting scrotal injections manage discomfort. Oral antibiotics prevent infection. Patients gradually resume activities, with sexual activity typically allowed after 4-6 weeks. Training on implant use occurs 3-6 weeks post-op.

Durability: Implants last about 10-12 years on average, varying by patient.

Patient Experiences and Satisfaction

Penile implants have the highest satisfaction rates among ED treatments—about 95% of patients report satisfaction, far exceeding pills (~50%) and injections (~30%). Those who failed other therapies often find implants life-changing, reporting improved erectile function, libido, partner satisfaction, and psychological well-being. Many say their sex life improved beyond younger years and would recommend or repeat the surgery. Implants are a definitive solution for men who need more than conservative treatments.

Best Clinics in Korea for Erectile Dysfunction Ailment

Listed below are the best clinics in Korea for erectile dysfunction ailment:

Clinic Name	Key Features	Special Techniques
SH Clinic Website	SH Clinic in Sinsa, Seoul stands out as Korea’s best destination for Erectile Dysfunction care because it unites cutting-edge regenerative medicine with a fully integrated, procedure-ready ecosystem under one roof. The SH Stem Cell Center designs personalized, comprehensive treatment plans and delivers advanced cell-based therapies for serious conditions—experience that directly aligns with the vascular and tissue-repair needs at the core of ED. Their demonstrated mastery of targeted biologics, from autologous stem cell applications for hair follicles to BMAC injections that calm inflammation and support structural recovery in joints, reflects a rigorous capability in cell handling and precision delivery. Complementing this is a surgical and energy-based portfolio honed in the SH Gynecology Clinic—vaginoplasty, HIFU, tightening, and implant procedures—showcasing meticulous technique in delicate, function-critical anatomy and efficient outpatient pathways. By combining stem-cell science, women’s healthcare expertise, aesthetic dermatology, and modern plastic surgery, SH Clinic provides a seamless, customizable pathway from evaluation to intervention and follow-up—precisely the multidisciplinary, regenerative, and minimally invasive approach discerning patients seek for ED.	Targeted biologics; autologous stem cell applications for hair follicles; BMAC injections.
Yezak Urology Website	Yezak Urology Clinic in Apgujeong is one of the largest urology centers in Seoul, bringing over 20 years of expertise in male enhancement and comprehensive men’s health. Equipped with advanced technology and rigorous safety systems, the clinic is led by a renowned urology specialist and developer of the 5-Point Fixed penile lengthening technique, and delivers care through a coordinated multi-specialist team. For men seeking care for erectile dysfunction, Yezak offers a full spectrum of options tailored to individual needs—from non-surgical treatments such as PDE5 inhibitors, intracavernosal injections, vacuum erection devices, and shockwave therapy, to definitive solutions including malleable and three-piece inflatable penile implants. Care plans also assess cardiovascular and hormonal contributors to ED, aligning precise diagnostics with targeted therapy to restore reliable sexual function and confidence.	5-Point Fixed penile lengthening technique; PDE5 inhibitors, intracavernosal injections, vacuum erection devices, shockwave therapy, malleable and three-piece inflatable penile implants.
THEPLUS Plastic Surgery Website	For readers exploring care pathways for erectile dysfunction in Korea and seeking complementary aesthetic or reconstructive support to restore confidence, THE PLUS Plastic Surgery in Garosu-gil, Gangnam, offers a world-class, research-driven model of care. Spanning four floors designed to deliver a seamless journey from consultation through surgery and post-operative skincare, the clinic is led by internationally recognized surgeons who unite function and beauty in their practice philosophy. Dr. Kim, a board-certified plastic surgeon and award-winning 3D implant researcher, is a leading expert in rhinoplasty and facial contouring and conducts annual educational sessions for peers. Dr. Jeong, President of the Korean Society of Plastic Surgeons, is renowned for combining function and aesthetics, frequently presenting and serving on panels at global forums. Dr. Lee, a board-certified breast augmentation specialist with experience at top hospitals including Seoul National University Hospital, emphasizes natural, long-lasting outcomes. Their collective commitment to safety, personalized communication, and academic leadership is reflected in regular contributions to scholarly journals, participation in international symposiums, and active roles in major professional societies. While THE PLUS Plastic Surgery is distinguished for expertise in rhinoplasty, revision rhinoplasty, and facial contouring rather than urologic care, its functional-aesthetic ethos, rigorous safety standards, and multidisciplinary collaboration make it a trusted partner for patients who may be addressing erectile dysfunction with specialized urology teams and seeking complementary procedures to enhance overall well-being and self-confidence. Director surgeons Dr. Jeong Jae Yong and Dr. Kim Taek Kyun are widely respected in Korea and abroad, with Dr. Kim’s seminal text, “Rebuilding Nose,” serving as a reference for rhinoplasty professionals. Their dedication to continuous learning, including educational outreach and webinars even during the COVID-19 era, underscores a clinic culture focused on excellence and outcomes—qualities that align with the comprehensive, patient-centered expectations of individuals navigating ED treatment and broader quality-of-life goals.	Rhinoplasty, revision rhinoplasty, and facial contouring; safety-focused, multidisciplinary collaboration.

SH Clinic

SH Clinic in Sinsa, Seoul stands out as Korea’s best destination for Erectile Dysfunction care because it unites cutting-edge regenerative medicine with a fully integrated, procedure-ready ecosystem under one roof. The SH Stem Cell Center designs personalized, comprehensive treatment plans and delivers advanced cell-based therapies for serious conditions—experience that directly aligns with the vascular and tissue-repair needs at the core of ED. Their demonstrated mastery of targeted biologics, from autologous stem cell applications for hair follicles to BMAC injections that calm inflammation and support structural recovery in joints, reflects a rigorous capability in cell handling and precision delivery. Complementing this is a surgical and energy-based portfolio honed in the SH Gynecology Clinic—vaginoplasty, HIFU, tightening, and implant procedures—showcasing meticulous technique in delicate, function-critical anatomy and efficient outpatient pathways. By combining stem-cell science, women’s healthcare expertise, aesthetic dermatology, and modern plastic surgery, SH Clinic provides a seamless, customizable pathway from evaluation to intervention and follow-up—precisely the multidisciplinary, regenerative, and minimally invasive approach discerning patients seek for ED.

You can check out their website here: SH Clinic Website

Yezak Urology

Yezak Urology Clinic in Apgujeong is one of the largest urology centers in Seoul, bringing over 20 years of expertise in male enhancement and comprehensive men’s health. Equipped with advanced technology and rigorous safety systems, the clinic is led by a renowned urology specialist and developer of the 5-Point Fixed penile lengthening technique, and delivers care through a coordinated multi-specialist team.

For men seeking care for erectile dysfunction, Yezak offers a full spectrum of options tailored to individual needs—from non-surgical treatments such as PDE5 inhibitors, intracavernosal injections, vacuum erection devices, and shockwave therapy, to definitive solutions including malleable and three-piece inflatable penile implants. Care plans also assess cardiovascular and hormonal contributors to ED, aligning precise diagnostics with targeted therapy to restore reliable sexual function and confidence.

You can check out their website here: Yezak Urology Website

THEPLUS Plastic Surgery

For readers exploring care pathways for erectile dysfunction in Korea and seeking complementary aesthetic or reconstructive support to restore confidence, THE PLUS Plastic Surgery in Garosu-gil, Gangnam, offers a world-class, research-driven model of care. Spanning four floors designed to deliver a seamless journey from consultation through surgery and post-operative skincare, the clinic is led by internationally recognized surgeons who unite function and beauty in their practice philosophy. Dr. Kim, a board-certified plastic surgeon and award-winning 3D implant researcher, is a leading expert in rhinoplasty and facial contouring and conducts annual educational sessions for peers. Dr. Jeong, President of the Korean Society of Plastic Surgeons, is renowned for combining function and aesthetics, frequently presenting and serving on panels at global forums. Dr. Lee, a board-certified breast augmentation specialist with experience at top hospitals including Seoul National University Hospital, emphasizes natural, long-lasting outcomes. Their collective commitment to safety, personalized communication, and academic leadership is reflected in regular contributions to scholarly journals, participation in international symposiums, and active roles in major professional societies.

While THE PLUS Plastic Surgery is distinguished for expertise in rhinoplasty, revision rhinoplasty, and facial contouring rather than urologic care, its functional-aesthetic ethos, rigorous safety standards, and multidisciplinary collaboration make it a trusted partner for patients who may be addressing erectile dysfunction with specialized urology teams and seeking complementary procedures to enhance overall well-being and self-confidence. Director surgeons Dr. Jeong Jae Yong and Dr. Kim Taek Kyun are widely respected in Korea and abroad, with Dr. Kim’s seminal text, “Rebuilding Nose,” serving as a reference for rhinoplasty professionals. Their dedication to continuous learning, including educational outreach and webinars even during the COVID-19 era, underscores a clinic culture focused on excellence and outcomes—qualities that align with the comprehensive, patient-centered expectations of individuals navigating ED treatment and broader quality-of-life goals.

You can check out their website here: THEPLUS Plastic Surgery Website

Medical Tourism for ED Treatment in South Korea

South Korea is a growing hub for medical tourism, especially for urological care.

Why Consider South Korea for ED Treatment?

South Korea offers highly skilled urologists and advanced technology, including robotic surgery that improves precision and recovery. Ten of the world’s top 100 urology university hospitals are in Seoul, which also has 279 urology clinics staffed by board-certified specialists.

Medical costs are competitive; for example, metastatic prostate cancer treatment averages $7,500 USD in Korea versus $31,400 USD in the USA. Foreign patients report high satisfaction (89.2/100), and over 1.17 million visited Korea for medical care in 2024, nearly doubling 2023’s numbers.

Beyond cost and quality, Korea offers affordable travel, rich culture, natural beauty, and excellent cuisine. The country promotes themed tourism like temple healing and traditional hanok stays, blending medical care with cultural experiences.

Process of Getting Procedure(s) in South Korea

International patients benefit from a streamlined system:

• Initial Consultation and Diagnosis: Includes medical history, physical exam, lab tests (blood, urinalysis), and advanced diagnostics like Duplex Ultrasound or Penile Biothesiometry. Major hospitals have International Healthcare Centers (IHCs) offering one-stop services, translation, appointment help, and cost estimates.
• Visa and Travel Arrangements: Medical Tourist Visa (C-3-3) is required, with documents like hospital invitation and financial proof. Visa processing takes about 14 days. Travel costs include airfare ($600-$1,500), accommodation ($30-$200+ per night), meals, local transport, and visa fees ($50-$100). Support services like the Medical Korea Information Center and 1330 Korea Travel Helpline assist patients.
• Hospital/Clinic Selection and Appointment: Patients can find accredited urology clinics via the Korean Urological Association. Many hospitals require appointments and offer English-speaking staff or interpreters. Registration and medical forms are completed on arrival.
• Treatment and Post-operative Follow-up: Clinics such as Stantop Urology & Andrology and RE:YOUTH offer stem cell therapy; Stantop and Adams Urology provide penile implants. Follow-up includes wound checks and device training. IHCs support ongoing care and communication.

Table 3: Key Steps for Medical Tourists in South Korea

Step	Key Actions	Relevant Support Services
1. Initial Consultation & Diagnosis	Provide detailed history, undergo exams and lab tests, possibly advanced diagnostics.	International Healthcare Centers (IHCs) offering one-stop service and translation in multiple languages.
2. Visa & Travel Arrangements	Apply for Medical Tourist Visa with hospital invitation, appointment confirmation, financial proof. Budget for travel and stay.	Medical Korea Information Center and 1330 Korea Travel Helpline provide consultation and interpreter services.
3. Hospital/Clinic Selection & Appointment	Research and select accredited clinics/hospitals, confirm English-speaking staff, register on arrival.	IHCs assist with appointments and escort services; bilingual staff available at major facilities.
4. Treatment & Post-operative Follow-up	Undergo chosen procedure, follow post-op care, attend follow-ups for wound checks and device training.	IHCs provide continuous care and follow-up communication; hospital staff handle discharge education.

Costs and Value: South Korea vs. Global Destinations

Understanding costs helps patients make informed choices.

Cost of Stem Cell Therapy in South Korea vs. Other Countries

• South Korea: Around $30,956 USD on average for ED stem cell therapy, with some reports ranging from $7,000 to $30,000 depending on treatment specifics.
• Turkey: Starting at $1,700 USD; packages including PRP and shockwave therapy range $3,000-$4,000.
• USA/UK: $4,000-$7,000 USD on average; packages up to $22,200 USD.
• Mexico: $1,500-$4,900 USD including exosomes and other therapies.
• Thailand: $1,800-$5,100 USD; all-inclusive packages may include additional therapies and accommodations.
• Germany: Among the most expensive, €21,900-€22,950 (~$23,500-$24,600 USD).

Cost of Penile Implants in South Korea vs. Other Countries

• South Korea: Malleable implants $5,000-$10,000 USD; inflatable implants $10,000-$20,000 USD; silicone implants $7,000-$15,000 USD. Costs cover hospital, surgeon, and post-op care.
• USA: $12,000-$20,000 USD out-of-pocket, depending on insurance.
• UK: $11,500-$23,000 USD including hospital and care.
• Turkey: $6,509-$10,600 USD including hospitalization and meals.
• Thailand: $2,957-$9,800 USD; average around $8,540 USD including anesthesia and rehab.
• India: Among the lowest costs; malleable implants ~$3,500 USD; inflatable implants up to $15,000 USD.
• Australia: $10,000-$20,000 AUD; some costs offset by insurance.

Overall Medical Tourism Expenses (Beyond Procedure Costs)

• Flights: $600-$1,500 USD depending on origin.
• Accommodation: Budget hotels $30-$60/night; mid-range $70-$150; luxury $200+.
• Meals and Transport: $20-$50/day for food; subway/bus rides $1-$2; taxis $5-$10 per short trip.
• Medical Visa: $50-$100 USD.
• Additional: Visa requirements vary; travel insurance recommended; currency exchange considerations.

Value Proposition for Medical Tourists

South Korea offers high-quality care at reasonable prices, advanced technology, and experienced professionals. Combined with cultural attractions and efficient infrastructure, it provides a compelling option for patients seeking effective ED treatment alongside a positive travel experience.

Conclusions

Erectile dysfunction is a common, multifaceted condition impacting physical and mental health. It is not an unavoidable part of aging and can signal serious systemic diseases, emphasizing the need for medical evaluation. Psychological stigma often delays treatment, so empathetic care that includes mental health support is vital. Stem cell therapy shows promise but currently lacks strong evidence and standardized protocols, requiring cautious consideration. Penile implants offer a highly effective, satisfying solution for men unresponsive to other treatments, with success linked to experienced surgeons. South Korea stands out as a top medical tourism destination, combining expert care, advanced technology, competitive costs, and excellent patient support. Decisions about ED treatment should always involve qualified healthcare professionals, thorough diagnosis, and clear understanding of risks, benefits, and costs.

References

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42