erectile dysfunction Flashcards
what is erectile dysfunction?
the constant inability to attain or maintain penile erections of sufficient quality to allow satisfactory sexual intercourse
what is the difference between and erect penis and a flaccid one?
when erect, the penis has more blood supply, so it is contracted
what are the 5 phases of an erection?
- flaccid
- latent (filling)
- Tumescent
- Full erection
- Rigid erection
- Detumescence
what are the organic causes of ED?
- 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
what are the psychogenic causes of ED?
- general
2. situational
what effect does cycling have on erectile dysfunction?
- long distance cycling associated with nerve compression in the perineum
- causing ED
what concerns are you looking for when assessing ED?
- Is this early presentation of vascular disease ? • Diabetes?
- Hypercholesterolaemia
- Hormonal problems ?
- Prostatic problems
what tests can be done to investigate ED?
- Serum lipids
- Fasting glucose
- Hormonal testing
- Ultrasound
- Nocturnal penile tumescence • Vascular studies of the penis
what treatment options are available for ED?
- medication
- implants
- vacuum devices
- prosthesis surgery
what type of medication is used in ED?
prostaglandins e.g. alprostadil. They are 2nd line treatment to PDE5 treatment failure.
why are prostaglandins used to treat ED?
they effectively cause vasodilation and smooth muscle relaxation
how are prostaglandins applied?
it is injected into the corpus cavernous of the penis
how do PDE5 work?
- they won’t cause an erection without sexual stimulation e.g. sildenafil, tadalafil, avanafil, vardenafil
what are the adverse effects of phosphodiesterase type 5 (PDE5)?
- flushing
- headache
- dyspepsia
- CV issues
how many doses of PDE5 should be given before deciding whether or not it works for the patient?
6-8 doses with no response despite receiving sexual stimulation