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Flashcards in ED Deck (21)
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1

What are the two main step in the normal physiology of an erection?

1. Increased penile arterial inflow (Parasympathetic)
2. Decreased venous outflow

2

MC etiology in ED

Endothelial dysfunction

3

What is key to an erection?

Circulation

4

Possible PEx findings in ED

1. Gynecomastia, Galactorrhea: High prolactin levels can cause ED
2. Penis plaques-Can cause Peyronies testis

5

What test would you use to evaluate sleep erections?

Nocturnal Penile Tumescence
"Postage Stamp"

6

How can we test for arterial insufficiency?

Penile Duplex US

7

How can we test for venous leakage?

Cavernosometry/Cavernosography

8

What do we measure with a Cavernosometry/Cavernosography?

Rate of inflow of saline required to maintain an erection

9

General/Lifestyle Treatment in ED

1. Determine if CV status is appropriate for sexual activity
2. Smoking cessation
3. Weight control
4. Possible change in medications

10

What is the overall effect of PDE-5-I

1. Vasodilatory effect
2. Maintain Erection

11

What is a major SE of PDE-5-I

Vision loss: Non-Arteritis anterior ischemic optic neuropathy

12

What drug is CI when taking PDE-5-1?

Nitrates

13

Which PDE-5-I do you NOT have to worry about taking after meals?

Tadalafil (Cialis)

14

Vacuum Erection Device (VED) MOA

Increases arterial blood flow into corpora cavernosa

15

How is a MUSE administered? List an example

Urethral Suppository
Prostaglandin E1

16

List the Intracavernosal Injection Triple Agent

Prostaglandin E1 + Phentolamine + Papaverine

17

What is the max dose of Intracavernosal Injections per week?

3 doses/week

18

What is the major risk/complication of Intracavernosal Injections?

Priapism: Erection >4 hrs

19

Priapism Treatment

Needle aspiration with injection of Phenylephrine (vasoconstrictor)

20

Venous leakage treatment

Constriction Ring

21

Indications for penile revascularization surgery (anastomosis of inferior epigastric artery to dorsal penile artery)

Focal arterial occlusion of cavernosal artery