Erectile dysfunction Flashcards

1
Q

5 phases of an erection (0-5):

A
0 - flaccid phase 
1 - latent (filling) phase
2 - tumescent phase 
3 - full erection phase 
4 - rigid erection phase 
5 - detumescence phase
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2
Q

mechanism of erection

A

cavernous artery dilates = muscle contracts

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3
Q

causes of impotence

A

organic: vascular/arterial, neurogenic, anatomical, secondary to surgery
psychogenic: situational, general
drugs and substance use: alcohol, hypnotics, diuretics, alpha and beta blockers, SSRIs
riding bikes

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4
Q

possible referrals for impotence

A

mental health services
cardiology
urology
endocrinology

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5
Q

lifestyle changes to treat ED

A
weight loss 
regular exercise - avoid long-distance bike rides 
healthy diet 
moderate alcohol consumption 
smoking cessation
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6
Q

3 treatment options for ED

A

Lifestyle changes
implants/ prosthesis surgery
medication

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7
Q

Medication options for ED

A

PDE5 - 1st line (sildenafil, tadalafil, vardenafil)

prostaglandin (PG) injection - 2nd line (alprostadil)

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8
Q

Physiology of erection

A
  1. Pudendal nerve activates nitric oxide
  2. This activates guanylate cyclase (converts GTP to cGMP)
  3. cGPM activates protein kinase G (PKG)
  4. PKG decreases intracellular Ca2+
  5. Low Ca2+ decreases smooth muscle tone and vasodilation of penile arteries = erection

a. Adenylate cyclase converts ATP to cAMP
b. cAMP activates protein kinase A (PKA)
- PKA acts same as PKG in above process

PDE converts cGMP to GTP and cAMP to ATP

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