ERECTILE DYSFUNCTION

LUCY NNEOMA NWAEKE#1011 MD4

Intro

Erectile dysfunction (ED), also known as impotence, is the inability to get and maintain an erection that is sufficient for satisfactory sexual intercourse.

It has a significant impact on quality of life

Signs and symptoms

Erectile dysfunction symptoms may include persistent:

Trouble getting an erection

Trouble keeping an erection

Reduced sexual desire

causes

Neurogenic: spinal cord and brain injuries

parkinson’s

alzheimer’s

multiple sclerosis

stroke Hormonal: pituitary gland tumors

low levels of testosterone

Arterial: peripheral vascular disease

HTN

decreased BF to the penis

carvasonal: peyronie’s disease

Surgery: radiation therapy

prostate and bladder surgery cancer surgery

surgery of the colon

Aging

Alcohols

Drugs

Obesity cigarette smoking

Physiological causes: anxiety

depression

relationship problems

mental disorders

Risk factors

Medical conditions

Using tobacco

Overweight

Certain medical treatment

injuries

Medications

Psychological conditions

Drug and alcohol abuse

complications

An unsatisfactory sex life

Stress or anxiety

Embarrassment or low self-esteem

Marital or relationship problems

The inability to get your partner pregnant

Tests and diagnosis

Physical examination

Blood tests

Urine tests

Ultrasound

Overnight erection test (NPT)

Psychological exam

Penile angiogram

MRA

treatment

Sildenafil (Viagra)

Tadalafil (Cialis)

Vardenafil (Levitra, Staxyn)

Other treatments

Alprostadil penis suppository

Alprostadil self-injection

Testosterone replacement therapy

BEFAR

penile pumps

Penile implants

Hormone treatment

Blood vessel surgery

counselling

Alternative treatment

Korean red ginseng (Panax ginseng)

Dehydroepiandrosterone (DHEA)

L-arginine

Acupuncture

Herbal viagra

Quit smoking

Loose weight

Get regular exercise

Get treatment for drug and alcohol problems

Work through relationship issues

Clinical case

a 56-year-old man who presents to his family physician for follow-up of hypertension control. During his history, he reports significant erectile dysfunction (ED) that has progressed over the past 8 months. This has been distressing to him and to his wife and has caused significant marital strife. He has been treated for hypertension for 4 to 5 years and is currently taking a combination of hydrochlorothiazide and atenolol with good blood pressure control..

His past history includes obesity and a sedentary lifestyle. His blood pressure is moderately controlled (146/92 mm Hg). At 69 inches tall, he weighs 248 pounds

He reports no morning erections, nocturnal erections, or spontaneous erections satisfactory for vaginal penetration. He has normal ejaculatory function pain or hematospermia. Physical examination is normal with normal genitalia, prostate examination, but a rotund abdomen that is nontender.

references

http://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/basics/risk-factors/con-20034244

http://www.imedicure.com/hometopics/erectile-dysfunction/

http://www.urologyhealth.org/urology/index.cfm?article=60