erectile dysfucntin Flashcards
division
1.organic
- vascular , hypertension, diabetes, lipidemia, smoking
- neuroendocrine - hypogonadism, hyperprolactinemia, thyroid problems - especially hypothyroidsim)
-neurogenic , stroke, brain/spinal cord injury
- medications: antidepressants, antihypertensives like bb
medical procedures TURP
alcohol abuse
trauma , pelivic fracture
peyroines disease
- psychogenic - depression, axiety(performace related)
- mixed
questionnaire
international index of erectile dysfunction questionnaire
22-25 - no ED
5-7 SEVERE ED
1ST LINE
2nd line
viagra
intracavernous injections
1ST LINE
2nd line
viagra
intracavernous injections
the most common disorders of sexual dysfunction is i
Most common sexual disorders in men is premature ejaculation and
erectile dysfunction.
def ED
consistent or
recurrent men’s inability to achieve and maintain an erection sufficient for satisfactory sexual
activity.
def priapism
painful erection >4 h that is unrelated to sexual stimulation
compartment syndrome
occurs when the pressure within a compartment increases, restricting the blood flow to the area and potentially damaging the muscles and nearby nerves.
in this context we are talking about priapsim
which part of penis if affected in priapsism
Only corpus cavernosum is affected. Corpus spongiosum is normal.
which part of penis if affected in priapsism
Only corpus cavernosum is affected. Corpus spongiosum is normal.
whats the pathiphys of priapism
normal influx of blood by artery but outflow venous is restricted
whats the pathiphys of priapism
normal influx of blood by artery but outflow venous is restricted
what surrounds the urethra
spongiosum
what surrounds the urethra
spongiosum
whats the diff between priapism and a norma erection
normal : glans penis is also hard
whats the diff between priapism and a norma erection
normal : glans penis is also hard
types of priapism and which one is urgent
ischemic (low flow) - emergency
non ischemic (high flow)
intermittent (stuttering)
which people are at risk for priapism
sickle cell
thalsemia, leukemia, MM
metabolic issues like gout and amyloidiosis
medications and priapsim
side effects of certain meds contribute especially to ischemic
- intracavernous injections for ED like papaverin
- antidepressants
- medications to treat ADHD
medications and priapsim
side effects of certain meds contribute especially to ischemic
- intracavernous injections for ED like papaverin
- antidepressants and antipsychotics
- medications to treat ADHD
Other random causes of priapism
A spider bite, scorpion sting or other toxic infections
Metabolic disorders including gout or amyloidosis
Neurogenic disorders, such as a spinal cord injury or syphilis
Cancers involving the penis
what nerve is responsible for having an erection
pudendal nerve which is also called dorsal penile nerve
types of erections
- Reflexogenic erections: These erections happen when something physically touches the genitals, triggering arousal.
- Psychogenic erections: These occur in response to mental stimuli, such as sexual memories or fantasies.
- Nocturnal erections: As the name implies, these happen during sleep. (Morning erections are typically the last nocturnal erection a man experiences during sleep.)
factors that can hinder an erection
diabtes, hypertentsio
age
anxiety , stress
drinking alcohol and antidperesants
what is premature ejaculation
either happens before or when the penis is in vagina the definition in terms of time is variable because its dependant on the PERSON and how satisfied he/partener is
people feel a loss of voluntary control over themselves
causes of premarure ejaculation
- an extra senitive penis
- eretile dysfucntion
- hormonal problems = oxytoxin
- low dopamine and seratonin
performance anxiety,
tx for premature ejecultation
behavioural therapy- tries to delay the ejaculation so teaches you how to ocntrol your body,like start and stop, squeeze therapy
counselling
medications- PRILIGY (dapoxetine) it inhibits the seratonin transporter so it has longer time to act
phases of erection
- emission - sperm travels from epididymis to the prostate to be mixed with seminal fluid
- expulsion - pelvic muscles contract to propel the sperm out
what happens if you have bothe ED AND PE
the ED should always be treated first because in many men with the treatment of the ED the PE willl naturally imporvs
what seems to be the main key player in PE
SERARTONIN
high levels - prolong ejaculation
low levels - quicken ejaculation
delayed ejaculation points
unable to ejaculate with partner or masturbation at all or it takes you long time, its normal to have a delayed one from time to time
some men can only ejaculate with mastrubation
again no universal def but 30 minss is around the ball park
causes of delayed
older age
diabetes
endocrine - hypothyrodisim, hyper prolactinemia
psychological - especially if you can get it by yourself
drugs- antidepressants
causes of delayed
older age
diabetes
endocrine - hypothyrodisim, hyper prolactinemia
psychological - especially if you can get it by yourself
drugs- antidepressants
anejaculation
Anejaculation is defined as the inability to ejaculate semen; . you have the sperm produced you just can’t expel it out
it’s possible to have an orgasm but no semen
