erectile dysfunction Flashcards

1
Q

what is erectile dysfunction?

A

the constant inability to attain or maintain penile erections of sufficient quality to allow satisfactory sexual intercourse

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2
Q

what is the difference between and erect penis and a flaccid one?

A

when erect, the penis has more blood supply, so it is contracted

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3
Q

what are the 5 phases of an erection?

A
  1. flaccid
  2. latent (filling)
  3. Tumescent
  4. Full erection
  5. Rigid erection
  6. Detumescence
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4
Q

what are the organic causes of ED?

A
  • vascular or arterial disease
  • Neurogenic e.g. Parkinson’s, Epilepsy, MS, stroke, Alzheimer’s
  • Anatomical (this includes issues within the structures of the penis)
  • Secondary to surgery
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5
Q

what are the psychogenic causes of ED?

A
  1. general

2. situational

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6
Q

what effect does cycling have on erectile dysfunction?

A
  • long distance cycling associated with nerve compression in the perineum
  • causing ED
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7
Q

what concerns are you looking for when assessing ED?

A
  • Is this early presentation of vascular disease ? • Diabetes?
  • Hypercholesterolaemia
  • Hormonal problems ?
  • Prostatic problems
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8
Q

what tests can be done to investigate ED?

A
  • Serum lipids
  • Fasting glucose
  • Hormonal testing
  • Ultrasound
  • Nocturnal penile tumescence • Vascular studies of the penis
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9
Q

what treatment options are available for ED?

A
  1. medication
  2. implants
  3. vacuum devices
  4. prosthesis surgery
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10
Q

what type of medication is used in ED?

A

prostaglandins e.g. alprostadil. They are 2nd line treatment to PDE5 treatment failure.

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11
Q

why are prostaglandins used to treat ED?

A

they effectively cause vasodilation and smooth muscle relaxation

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12
Q

how are prostaglandins applied?

A

it is injected into the corpus cavernous of the penis

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13
Q

how do PDE5 work?

A
  1. they won’t cause an erection without sexual stimulation e.g. sildenafil, tadalafil, avanafil, vardenafil
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14
Q

what are the adverse effects of phosphodiesterase type 5 (PDE5)?

A
  1. flushing
  2. headache
  3. dyspepsia
  4. CV issues
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15
Q

how many doses of PDE5 should be given before deciding whether or not it works for the patient?

A

6-8 doses with no response despite receiving sexual stimulation

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16
Q

what is penile prosthesis?

A

insertion of a penile implant, that is coated with inhibizone, into the penis and then it is pumped causing an artificial erection.