ED Flashcards
(21 cards)
What are the two main step in the normal physiology of an erection?
- Increased penile arterial inflow (Parasympathetic)
2. Decreased venous outflow
MC etiology in ED
Endothelial dysfunction
What is key to an erection?
Circulation
Possible PEx findings in ED
- Gynecomastia, Galactorrhea: High prolactin levels can cause ED
- Penis plaques-Can cause Peyronies testis
What test would you use to evaluate sleep erections?
Nocturnal Penile Tumescence
“Postage Stamp”
How can we test for arterial insufficiency?
Penile Duplex US
How can we test for venous leakage?
Cavernosometry/Cavernosography
What do we measure with a Cavernosometry/Cavernosography?
Rate of inflow of saline required to maintain an erection
General/Lifestyle Treatment in ED
- Determine if CV status is appropriate for sexual activity
- Smoking cessation
- Weight control
- Possible change in medications
What is the overall effect of PDE-5-I
- Vasodilatory effect
2. Maintain Erection
What is a major SE of PDE-5-I
Vision loss: Non-Arteritis anterior ischemic optic neuropathy
What drug is CI when taking PDE-5-1?
Nitrates
Which PDE-5-I do you NOT have to worry about taking after meals?
Tadalafil (Cialis)
Vacuum Erection Device (VED) MOA
Increases arterial blood flow into corpora cavernosa
How is a MUSE administered? List an example
Urethral Suppository
Prostaglandin E1
List the Intracavernosal Injection Triple Agent
Prostaglandin E1 + Phentolamine + Papaverine
What is the max dose of Intracavernosal Injections per week?
3 doses/week
What is the major risk/complication of Intracavernosal Injections?
Priapism: Erection >4 hrs
Priapism Treatment
Needle aspiration with injection of Phenylephrine (vasoconstrictor)
Venous leakage treatment
Constriction Ring
Indications for penile revascularization surgery (anastomosis of inferior epigastric artery to dorsal penile artery)
Focal arterial occlusion of cavernosal artery
