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Erectile Dysfunction (Aetiology (Hyperthyroidism, Increased prolactin,…
Erectile Dysfunction
Aetiology
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Smoking, alcohol + diabetes all reduce NO autonomic neuropathy
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Drugs: digoxin, beta-blockers, diuretics, antipsychotics, antidepressants + narcotics - can all cause low testosterone
Treatment
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Oral phosphodiesterase inhibitors e.g. sildenafil (Viagra) 1 hour pre sex. Food + alcohol decrease absorption
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Erectile Physiology
NO via cGMP and Ca2+ hyperpolarizes and thus relaxes vascular and trabecular smooth muscle cells, allowing engorgement
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In the flaccid state, there is sympathetic tone (T11-L2) - arterioles are constricted
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Investigations
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Lab Tests
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Morning testosterone. If this is low, perform prolactin, FSH, LH tests
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Definition
The persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance
Priapism = Prolonged erection. If the erection lasts 4 hours, there is risk of permanent ischaemic damage to the corpora.