Erectile dysfunction

Question 1

What is erectile dysfunction

Answer 1

Failure to initiate an erection or to maintain and erection until ejaculation

Question 2

What is an erection the result of

Answer 2

increased vascularity of the penis controlled via the sacral parasympathetic outflow
The nervous pathways for ejaculation are centred on the lumbar sympathetics
Point and shoot (PS and S)

Question 3

potential causes of erectile dysfunction

Answer 3

vascular disease, autonomic neuropathy (most commonly from DM) and nerve damage after pelvic surgery
psychological factors
endocrine factors (hypogonadism)
alcohol and drugs
diuretics

Question 4

what is suggestive of psychogenic erectile dysfunction

Answer 4

the presence of morning and nocturnal erections

pt may respond to psychosocial counselling

Question 5

First choice therapy erectile dysfunction

Answer 5

Phosphodiesterase type-5 inhibitors e.g. sildenafil, tadalafil, vardenafil
inc penile blood flow

Question 6

risk factors erectile dysfunction

Answer 6

many in common with CVS disease
lack of exercise
obesity
smoking
hypercholesterolaemia
metabolic syndrome - diabetes x3 risk
radical prostatectomy is a common cause