penis things

Question 1

what are the causes of ED?

Answer 1

• vascular - risk factors as per IHD
• neurological e.g diabetes, CVA, spinal injury, parkinsons
• Hormonal e.g low testosterone
• medication e.g anti depressants, beta blockers
• psychological

Question 2

what is ED important?

Answer 2

• sensitive marker of early vascular disease
• very important to asses CVS risk
• can potentially mitigate risk of MI, CVA etc.

Question 3

how can you differentiate between organic and psychological E.D?

Answer 3

speed of onset

• gradual = organic
• sudden = psychological

also, presence of early morning erections absent in organic.

Question 4

what investigations can be done for ED?

Answer 4

• asses vascular risk factors e.g BP, lipids, glucose, smoking
• early morning testosterone
• prolactin, LH, FSH, PSA is debatable

Question 5

how can ED be managed?

Answer 5

• psychosexual counselling if psychological
• PDE5 inhibitors
• treat low testosterone if present
• intracavernosal prostaglandin injections
• vacuums tumescence device
• inflatable penile prosthesis

Question 6

what is phimosis and how does it differ from paraphimosis?

Answer 6

inability to retract the foreskin - can be physiological e.g in a child (if persists into adulthood offer circumcision)| or scarred.

unlike paraphimosis where foreskin is retracted and can’t be rolled back up

Question 7

what is priapism?

Answer 7

sustained painful erection that persists without sexual stimulation

• common cause is drugs or over use of PD5 inhibitors
• can be caused by venous occlusion
• aspirate to treat or get them to exercise to move blood away from penis

if its high flow, treat with painless angioembolisation of the fistula.

Question 8

what are some of the risk factors for forniers gangrene aka necrotising fascilata?

Answer 8

• older age
• diabetes
• obesity
• cardiovascular disorders
• alcoholism
• long-term corticosteroid treatment
• malignancy
• HIV
• trauma

Question 9

how can you get fourniers gangrene?

Answer 9

In general, organisms from the urinary tract spread along the fascial planes to involve the penis and scrotum.

Question 10

how can fourniers gangrene be treated?

Answer 10

get surgical debribement to treat

Question 11

what is pirones disease?

Answer 11

fibrosis in the corpus cavenosa = bend in penis. associated with drupypetens contracture

Question 12

what is a penile fracture?

Answer 12

rupture of the tunica albigenea - blood contained by bucks fascia = get aubergine deformation.

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