erectile dysfunction

Question 1

what is erectile dysfunction?

Answer 1

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

Question 2

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

Answer 2

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

Question 3

what are the 5 phases of an erection?

Answer 3

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

Question 4

what are the organic causes of ED?

Answer 4

• 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

Question 5

what are the psychogenic causes of ED?

Answer 5

1. general

2. situational

Question 6

what effect does cycling have on erectile dysfunction?

Answer 6

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

Question 7

what concerns are you looking for when assessing ED?

Answer 7

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

Question 8

what tests can be done to investigate ED?

Answer 8

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

Question 9

what treatment options are available for ED?

Answer 9

1. medication
2. implants
3. vacuum devices
4. prosthesis surgery

Question 10

what type of medication is used in ED?

Answer 10

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

Question 11

why are prostaglandins used to treat ED?

Answer 11

they effectively cause vasodilation and smooth muscle relaxation

Question 12

how are prostaglandins applied?

Answer 12

it is injected into the corpus cavernous of the penis

Question 13

how do PDE5 work?

Answer 13

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

Question 14

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

Answer 14

1. flushing
2. headache
3. dyspepsia
4. CV issues

Question 15

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

Answer 15

6-8 doses with no response despite receiving sexual stimulation

Question 16

what is penile prosthesis?

Answer 16

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