ED and BPH - Exam 2 Flashcards
how does erection occur?
increased arterial flow, relaxation of smooth musculature in both corpora cavernous, increased venous resistance
muscle contraction increases rigidity of penis w/ increase in intra-cavernous mmHg > systolic BP
what is erectile dysfunction?
consistent inability to generate or maintain and erection
ED etiologies?
vascular, neurogenic, hormonal, drug induced, psychogenic, Peyronie’s Disease
arterial vascular etiology of ED
caused by arterial obstruction
increased flow gives you erection, so obstruction would decrease flow, so then no erection
venous vascular etiology of ED
caused by venous leak
leakage would decrease venous resistance -> can develop erection, but can’t maintain it
what nervous system makes pt develop an erection? what NS maintains the erection? what causes the dysfunction?
erection develop is autonomic nervous system function
maintaining erection is parasympathetic nervous system
damage to either can cause dysfunction
neurogenic causes of ED
MS, Parkinson’s, CVA, spinal injury/tumor
d/t damage to autonomic NS and/or parasympathetic NS
how does hypogonadism cause ED?
b/c have decrease in testosterone, so decrease erection
how does hyperprolactinemia and HPA dysfunction cause ED?
b/c have decrease in GnRH -> decr testosterone -> decr erection
what drugs cause ED?
antihypertensives (BB’s, diuretics, alpha-agonists), antidepressants (SSRIs), opioids, 5-alpha-reductase inhibitors (finasteride)
ED caused by psychogenic, occurs in?
younger people
what is Peyronie’s disease? what type of cause of ED?
penile deformity or curvature of penis due to scarring and fibrosis -> mechanical cause of ED
ED may be an early of what?
early sign of CAD
ED and CAD develop from what?
endothelial dysfunction
endothelial dysfunction results from? imbalance b/w?
decrease in NO, thus impaired arterial vasodilation
imbalance b/w vasodilation and vasoconstriction
ED w/o obvious caused should be screened for what? why?
for CVD (esp before initiating pharmacologic therapy for sexual dysfunction)
b/c of increased cardiac risk associated with sexual activity
what is the etiology of Peyronie’s disease?
subtle trauma to penis and subsequent scarring and development of fibrous plaque -> during erection causes curvature
loss of penile length means?
Peyronie’s disease
what is SHIM? what does it do?
sexual health inventory for men
classifies severity of ED dysfunction into 5 categories
5 categories of SHIM
severe, moderate, mild-moderate, no ED (based on score of over 6 months)
men that are sexually competent and then all of a sudden one night they can’t perform, means what?
psychogenic ED
ex: performance anxiety, current sexual partner issues, emotional problems
sporadic ED problems that become more chronic, means what?
more of an organic cause
signs of hypogonadism?
hypogonadism can contribute to ED
sign:
- lack of/loss of normal male hair patterns
- gynecomastia
- small testes
lack of cremasteric reflex in pt that has ED may indicate?
neurogenic disease