Erectile Dysfunction

Question 1

What is meant by erectile dysfunction

Answer 1

Persistent inability to attain and maintain an erection- physical or psychological causes as well as side effects of drugs

Question 2

What is the treatment of erectile dysfunction

Answer 2

First line: phosphodiesterase type- 5 inhibitor
-increases blood flow to the penis- still requires sexual stimulation
Short acting: avanafil, silendafil, and verendafil- occasional use as required
Longer acting: tadalafil- used as required, or an as a regular lower daily dose to allow spontaneous sexual activity

Patients should have 6 doses at the maximum dose (with sexual stimulation) before being classified as a non-responder

Second line: intracavernosal, intraurethral or topical alprostadil
-under careful medical supervision

Question 3

What life Style changes would you recommend for someone with erectile dysfunction

Answer 3

Smoking cessation
Reduce alcohol intake

Question 4

What are the side effects of phosphodiesterase type- 5 inhibitor

Answer 4

Flushing
Dizziness
Nasal congestion
Migraine

Question 5

What are the contraindications of phosphodiesterase type- 5 inhibitor

Answer 5

Patients taking nitrates/ have hypotension
Patients with unstable angina/ stroke
Patients with angina during sex
Patients who should have sexual activity

Question 6

What do you do if you have priapism

Answer 6

Means erection lasting more than 4 hours - seek medical attention

Question 7

What are the interactions phosphodiesterase type- 5 inhibitor

Answer 7

Nitrates
Alpha-blockers

This is because it leads to hypotension even more

Question 8

What advise would you give to a patient who is on alprostadil

Answer 8

Wear condom if partner is of child bearing age, pregnant or lactating