Erectile Dysfunction Flashcards
Erectile Dysfunciton
Inability to attain or maintain an erect penis that allows for satisfactory sexual performance
Increases with age
Vascular risk factors
Atherosclerosis
HT
PVD
*Atherosclerosis goes hand in hand with heart conditions, should have a full workup done
Drug risk factors
Alcohol Antiandrogens Antilipidemic agents Antihypertensives Diuretics Nicotine Major tranquilizers Tricyclic antidepressants Nicotine, marijuana SSRIs *Beta blockers are biggest one for antihypertensives
Endocrine risk factors
Obesity
DM
Genitourinary risk factors
Radical prostatectomy
Prostatitis
Renal failure
Neurologic risk factors
Parkinson’s
Cerebrovascular disease
Tumors/trauma to spine
Psychologic risk factors
Stress
Depression
Anxiety
Fear of failure to perform
Other risk factors….
Aging
Blood tests for diagnosis
Checking:
- testosterone levels
- blood glucose
- lipid
- thyroid and prolactin levels
Diagnosing ED
History (health, psychosocial, sexual) Physical exam DRE to assess prostate Blood tests Nocturnal penile tumescence and rigidity testing Vascular studies
Vardenafil
Tadalafil
Sildenafil
PDE 5
30 min - 1 hr before sex, no more than 1 in 24 horus
S/E: headache, dyspepsia, flushing, nasal congestion
Rare S/E: blurred vision, sudden hearing loss, priapism
Alprostadil injection
Sub q in penis, 20-30 min before sex
Other ways to treat ED
Vacuum constriction device
Intra-urethral devices
Penile implants
Sexual counseling
Priapism
Erection lasting longer than 4 hours
Not relieved by ejaculation
-common in sickle cell anemia because of sickle cell crisis; ischemia possible if blood issue
-can be s/e of meds and if so no ischemic tissue then
Treatment:
-needle aspiration, 16 gauge
-inject terbutaline or phenylephrine
