Conditions male's health

Question 1

What are causes of Erectile dysfunction ? (6 things)

Answer 1

1. Vasculogenic (most common)
   - CVD - HTN, high cholesterol, DM, smoking, pelvic surgery
2. neurogenic
   - MS, Parkinsons, stroke, spinal cord trauma, CNS tumours
3. Anatomical/ structural
4. Hormonal
   - Thyroid disease, bushings, pituitary disease, brain injury
5. Psychogenic
   - Performance anxiety
   - Stress
   - Psychiatric illnesses (depression, schizophrenia etc)
6. Drug related
   - Anti hypertensives
   - Anti-arrhythmic drugs
   - Anti psychotics
   - Anti depressants

Question 2

How do you manage Erectile dysfunction? (primary and secondary care)

Answer 2

Primary care:

1. Prescribe a PDE-5 inhibitor (Sildenafil 50mg)
   - regardless of the cause
2. Lifestyle advice:
   - Lose weight
   - Reduce alcohol
   - Reduce smoking
   - Stop unlicensed herbal remedies

Secondary care:

3. Vacuum erection devices (FIRST LINE)
4. Intracavernous injection (SECOND LINE)
5. Penile prosthesis (THIRD LINE)