Erectile dysfunction

Question 1

What is erectile dysfunction

What is it most commonly related to

Answer 1

inability to attain or sustain an erection satisfactory for intercourse

vascular, neurologic, psychologic, and hormonal disorders

Question 2

What are the risk factors for ED

Answer 2

DM
HTN
hypercholesterolemia
ASCVD
depression
S/p surgical or radiation tx of prostate CA

Question 3

How many types of ED are there

Answer 3

2
*1 is acquired later in life and one occurs at puberty

Question 4

What are psychological causes of ED that must be considered

Answer 4

Anxiety
guilt
depression
relational conflict or distress

Question 5

What is the most common vascular cause of ED

What is the primary source

Answer 5

atherosclerosis or cavernous arteries of the penis

smoking and diabetes

Question 6

What are some common drug classes that can cause ED

Answer 6

Antihypertensives
CNS drugs (anxiolytics)
MISC (chemo, anticholinergics)

Question 7

When is psychogenic ED suggested

Answer 7

young healthy men with abrupt onset
hx of ED with spontaneous improvement
generally have normal nocturnal erections

Question 8

What is peyronies disease

Answer 8

Fibrous bands or plaques in the genitals that will cause the penis to bend with an erection = pain

Question 9

How do you evaluate penile vasculature

Answer 9

Duplex US after injecting a triple mix of ‘trimix’ of
- prostaglandin E1
- Papervine
- Phetolamine

Question 10

What is the functions of a nocturnal tumescence monitor

Answer 10

Measures sleep-entrained eriectile episodes

differentiates b/n organic and psychogenic etiology

Question 11

How do you treat erectile dysfuntion

When should devices /tx be rendered ineffective

Answer 11

oral PDE-5i (1st line)
vacuum erection device

after trying >5 times with no result

Question 12

How do phosphodiesterase inhibitors work

What are they

Answer 12

promote smooth muscle relaxation

sildenafil, tadalafil, avanafil, verdenafil

Question 13

What type of device can help with ED if they can develop an erection but are unable to sustain it

Answer 13

constriction ring that is places around the base of the erect penis

Question 14

What device can be used in those who are unable to develop an erection

Answer 14

vacuum device that will draw blood into the penis and then use a constriction ring to sustain the erection

Question 15

What are the complications with devices used in ED

Answer 15

bruising, coldness of the penis tip, and lack of spontineity

Question 16

What is the definition of male infertility

When should investigation occur with women over 35

Answer 16

inability of a couple to conceive a child after a YEAR of unprotected sex

after 6 months of no conception with unprotected sex

Question 17

How are labs run when working up male infertlity

Answer 17

semen analyses x2
collection after 48-72 hours of abstinence
analysis within one hour of collection

Question 18

What is oligospermia

What is azoospermia

Answer 18

<20million sperm/ml

No sperm

Question 19

What can effect sperm motility

Answer 19

Varicocele
anti-sperm antibodies
infection
drugs
ejaculatory duct obstruction

Question 20

What can effect sperm morphology

Answer 20

varicocele
infection
exposure to chemicals

Question 21

What will labs look like in primary testicular failure

Secondary testicular failure?

Answer 21

Low T
high FSH / LH

Low T, FSH, and LH

Question 22

What genetic abnormalities cna lead to ED

Answer 22

Y chromosome deletions
klinefelters (47XXY, m/c)
CF