ED and Prostate Cancer/PSA Flashcards
What are the main mechanisms of an erection?
1) Parasympathetic Innervation
2) Arteriolar Dilation
3) Smooth muscle relaxation
4) Testosterone
What chemical can help smooth muscle relaxation to help bring about an erection?
Nitric Oxide (Vasodilator) -> V cytoplasmic Ca2+
What are the 2 main causes of ED?
1) Psychogenic
2) Organic e.g. vasculogenic, neurogenic
What are the main characteristics of psychogenic ED?
1) Affects young males
2) Situational
3) Sudden
What are the main risk factors for ED?
1) Smoking
2) Obesity
3) Sedentary Lifestyle
4) Diabetes Mellitus
What is the non-pharmacological management of ED?
1) Lose weight, stop smoking
2) Education and counselling of partner/patient
What is priaprism?
Prolonged erection lasting over 4 hours
What are the 3 lines of pharmacological management for ED?
1) Phosphodiesterase Inhibitors –> Vasodilation and arterial BF to penis
2) Intracavernous injections/Vacuum devices
3) Penile Prosthesis Implantation
What is a potential problem of priaprism?
Could cause permanent ischaemic damage
What function does the prostate have?
It secretes proteolytic enzymes into the semen to break down clotting factors to allow for ejaculation
Which anatomical zone of the prostate does cancer normally affect and where could it metastasise to?
- Peripheral Zone
Metastasises to either the lymph nodes or the bone
What investigations would be carried out for prostate cancer?
1) PSA - Serum
2) PCA3 and Gene Fusion products - Urine
3) DRE - Hard, irregular and craggy
4) Prostate biopsy, history of LUTS and trans-rectal USS
What can cause elevated PSA levels?
1) BPE
2) Prostatitis
3) UTI
What grading system is used in prostate cancer?
Gleason grading (Higher score = more aggressive)
How is localised prostate cancer treated?
Observation
Radiotherapy (Beam)
Radical prostatectomy
Adjuvant Hormones
