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Erectile Dysfunction (Pathophysiology (The autonomic parasympathetic flow…
Erectile Dysfunction
Pathophysiology
The autonomic parasympathetic flow causes an increased release of NO (vasodilator) this dilates the arteries. Causes the corpus cavernous to fill with blood. the erection continues until the autonomic stimulation stops.
Normally an erection happens due to an increase in blood flow and vascularity of the penis. Stimulated by sacral parasympathetic flow.
The NO causes there to be a build up of cGMP and means that Ca2+ activates K+ channels. This causes hyperpolarisation and relaxed vascular or trabecular smooth muscle cells
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The flow of blood out of the penis via veins is restricted by the veins coming close to the periphery of the skin
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Diagnosis
Look at FSH, LH and testosterone
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FBC, U&E, LFT and Blood glucose
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Treatment
Stage 2: if that doesn't work use a vacuum device. Penis is placed in a plastic container and air is removed
Stage 3: use a penile prosthesis . Pump is placed in the penis so a manual erection can be achieved. Or do a corpus cavernous tissue engineering
Stage 1: Treat the psychological or the physical problem first. Through reducing risk factors and introducing a use a Phosphodiesterase drug/ Increases the amount of cGMP and means there is more vasodilation . E.g Viagra
SE of phosphodiesterase medication: headaches , flushing , dyspepsia or a stuffy nose. DO NOT USE ON PATIENTS with a peptic ulcer, MS or unstable angina
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Definition: this is the condition that occurs when the patient is unable to initiate or maintain an erection until ejaculation