2.2.1 Treatment of Male Sexual Disorders Flashcards

1
Q

What are some of the meds indicated in causing ED?

A

Anti-HTN meds, Psychological meds, Hormonal meds, H2 receptor blockers, Cold medicine preparations

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2
Q

What is the #1 cause of erectile dysfunction?

A

Ateriogenic/vasculogenic

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3
Q

What are three causes of psychological ED?

A

Depression, stress, matrimonial discord

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4
Q

What are some of the associated conditions with retrograde ejaculation?

A

Diabetes, neurologic conditions, surgery, medications

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5
Q

What is libido?

A

The sexual drive or desire to engage in sexual activity

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6
Q

What is a common ejaculatory disorder in young men? How is it treated?

A

Premature ejaculation; Paxil (serotonin reuptake inhibitor)

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7
Q

When diabetic patients typically affected by ED?

A

10-15 years earlier

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8
Q
A
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9
Q

What is one of the terrible effects of PDE5 inhibitors?

A

NAION (non-arteritic anterior ischemic optic neuropathy)

43 cases to date

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10
Q

What is the treatment of high flow priapism?

A

Embolization of high flow priapism

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11
Q

How can libido be evaluated?

A

AM testosterone, general medical evaluation, psych evaluation

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12
Q

What is the prevelance of ED?

A

30 million men in US

52% of men b/t 40 and 70

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13
Q

How does a boner occur?

A

More blood going into the penis than going out

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14
Q

What is the MOA of viagra (PDE5 inhibitor)?

A
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15
Q

Where did priapism get its name?

A

Priapus - the god of fertility and nature

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16
Q

What are some of the things that can affect libido?

A

Testosterone levels (most important), chronic dz, depression, fatigue

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17
Q

What are the roles of the sympathetic and parasympthetic system in penis physiology?

A

Parasympathetic: vasodilation for erection (P for point)

Sympathetic: responsible for ejaculation (S for shoot)

18
Q

What are some of the risk factors for ED?

A
19
Q

What are the characteristics and causes of high flow priapism?

A
20
Q

What is the mechanism of ED in diabetic patients?

A

Small vessel dz affects inflow into penis

Small vessel dz to the cavernosal nerves affects sympathetic input

21
Q

What are some of the treatment options?

A

oral agents, constriction device/VED, intracavernosal injections

22
Q

What are some of the oral treatments for ED?

A

PDE5 inhibitors (viagra, levitra, cialis)

Testosterone, “The Ropes”, Yohimbine

Apomorphine

23
Q

What is ED? What is its other name?

A

The persistent inability to achieve or maintain an erection sufficient for intercourse

Impotence

24
Q

What are the 4 types of erectile dysfunction?

A

Arteriogenic/vasculogenic

Neurologic

Venous outflow

Psychogenic

25
Q

What drugs have been indicated in ED?

A

Alcohol, marijuana, cocaine, cigarettes

26
Q

What do you know about Levitra?

A
27
Q

What are some of the treatments for libido?

A

Replace testosterone (if safe and indicated)

Treat illness or depression

28
Q

What are the characteristics and causes of low flow priapism?

A
29
Q

What is the most recent PDE5 inhibitor on the market?

A

Cialis

30
Q

Why is surgery a risk factor for ED?

A

May affect cavernosal nerves

31
Q

What is the pathophysiology of post prostatectomy ED?

A
32
Q

What are the different classifications of male sexual dysfunction?

A

Libido, Erectile Function (impotence, priapism), Disorders of Ejaculation

33
Q

What are the contraindications for viagra?

A

Patients on nitrates, w/ unstable angina, recent MI or stroke

34
Q

What is the Muse?

A
35
Q

How can the diagnosis of ED be made?

A

History and physical

US of penile arteries

X-ray tests of veins (venous leak)

Testosterone levels

36
Q

What are some of the cellular mechanisms involved in erectile function?

A
37
Q

What % of patients with diabetes will suffer from ED across all ages?

A

20-85% (both T1DM/T2DM)

38
Q

What are some pros and cons of the penis vaccum (vaccum erection device)

A
39
Q

What is this? What causes it?

A

Priapism - persistent erection for more than 4 hours (low/high flow)

40
Q

What is Anejaculation?

A

disruption of sympathetic outflow (neurologic conditon or post retroperitoneal surgery)

41
Q

What are the three types of treatment for low flow priapism?

A

Oral - rarely works

Irrigation

Shunts (winters, Al-Ghorab, Quackels, Grayhack)

42
Q

What is one of the most effective treatments that leads to natural erections?

A

intracorporal injections