Which drugs can cause ED?
What are the most common arteriogenic causes of ED?
What the options if PDE5 inhibitors fail?
Intra-cavernosum injection to directly cause vasodilation Penis pump - sucks venous blood in and bands around base Implanted, inflatable devices that sit in the cavernosal body
What is Peyronie disease?
Weakening of the cavernosum due to plaques causing ED
What do you elicit on Hx?
Sexual Hx - ?Partner specific, Libido, premature ejaculation Nocturnal erection
CVD risk factors
What do you do Ix for ED?
Fasting glucose Fasting cholesterol ECG Testosterone, LH, and prolactin TFT's PSA
What is the most common cause ED overall?
What are the common side effects of PDE5 inhibitors
Headaches - tolerance develops
What are the organic causes of ED?
Vasculogenic (arteriogenic, cavernosal, mixed)
How do you treat ED?
Correct underlying disease if possible
Phosphodiesterase inhibitors (viagra) - most response to it
What do you do on Ex for ED?
What is the most common cause of ED in patients in the 20s?
Why might PDE5 inhibitors failed?
Failure to use adequate sexual stimulation
Failure to use adequate dose
Failure to wait long enough from dosing to sexual stimulation
Which drugs are interact with PDE5 inhibitors? Why?
Risk of hypotension due to vasodilation
How can neurogenic causes be organised?
How must PDE5 Inhibitors be used?
Consider their half-life in association with sexual stimulation - The drug on its own will not causes an erection