Erectile dysfunction Flashcards
What are the causes and contributing factors to erectile dysfunction?
Vascular disease
Autonomic neuropathy
Medications
Psychogenic - anxiety, depression
Endocrine causes - prolactinoma, hypogonadism
Pelvic surgery
Anatomical abnormalities
What is the clinical presentation of erectile dysfunction?
Reduced sexual desire
Difficulty in ejaculation
Anxiety or depression related to sexual performance
What are the signs that suggest an organic cause?
Lacking erectons
Slow-onset
Normal libido
What are the signs that suggest a psychogenic cause?
Situational
High levels of stress
Still having early morning erections
What investigations are performed in the diagnosis of erectile dysfunction?
Detailed sexual and psychological history
FBC
U&E
TFTs
Lipid profile
Testosterone
Prolactin
What is the management of erectile dysfunction?
Psychosexual therapy
Oral phosphodiesterase inhibitors - sildenafil
Vacuum erection devices
Intra-cavernosal injections to increase blood flow
Penile prostheses for cases resistant to other treatments
What are the contraindications for sildenafil?
Individuals taking nitrates
Hypertension/hypotension
Arrhythmias
Unstable angina
Stroke
MI
What are the cautions for sildenafil use?
Patients with angina
Peptic ulcers
Liver or kidney impairment
Peyronie’s disease
Complex antihypertensive regimes
