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ERECTILE DYSFUNCTION
LUCY NNEOMA NWAEKE#1011 MD4
Intro
Erectile dysfunction (ED), also known as impotence, is the inability to get and maintain an erection that is sufficient for satisfactory sexual intercourse.
It has a significant impact on quality of life
Signs and symptoms
Erectile dysfunction symptoms may include persistent:
Trouble getting an erection
Trouble keeping an erection
Reduced sexual desire
causes
Neurogenic: spinal cord and brain injuries
parkinson’s
alzheimer’s
multiple sclerosis
stroke Hormonal: pituitary gland tumors
low levels of testosterone
Arterial: peripheral vascular disease
HTN
decreased BF to the penis
carvasonal: peyronie’s disease
Surgery: radiation therapy
prostate and bladder surgery cancer surgery
surgery of the colon
Aging
Alcohols
Drugs
Obesity cigarette smoking
Physiological causes: anxiety
depression
relationship problems
mental disorders
Risk factors
Medical conditions
Using tobacco
Overweight
Certain medical treatment
injuries
Medications
Psychological conditions
Drug and alcohol abuse
complications
An unsatisfactory sex life
Stress or anxiety
Embarrassment or low self-esteem
Marital or relationship problems
The inability to get your partner pregnant
Tests and diagnosis
Physical examination
Blood tests
Urine tests
Ultrasound
Overnight erection test (NPT)
Psychological exam
Penile angiogram
MRA
treatment
Sildenafil (Viagra)
Tadalafil (Cialis)
Vardenafil (Levitra, Staxyn)
Other treatments
Alprostadil penis suppository
Alprostadil self-injection
Testosterone replacement therapy
BEFAR
penile pumps
Penile implants
Hormone treatment
Blood vessel surgery
counselling
Alternative treatment
Korean red ginseng (Panax ginseng)
Dehydroepiandrosterone (DHEA)
L-arginine
Acupuncture
Herbal viagra
Quit smoking
Loose weight
Get regular exercise
Get treatment for drug and alcohol problems
Work through relationship issues
Clinical case
a 56-year-old man who presents to his family physician for follow-up of hypertension control. During his history, he reports significant erectile dysfunction (ED) that has progressed over the past 8 months. This has been distressing to him and to his wife and has caused significant marital strife. He has been treated for hypertension for 4 to 5 years and is currently taking a combination of hydrochlorothiazide and atenolol with good blood pressure control..
His past history includes obesity and a sedentary lifestyle. His blood pressure is moderately controlled (146/92 mm Hg). At 69 inches tall, he weighs 248 pounds
He reports no morning erections, nocturnal erections, or spontaneous erections satisfactory for vaginal penetration. He has normal ejaculatory function pain or hematospermia. Physical examination is normal with normal genitalia, prostate examination, but a rotund abdomen that is nontender.
references
http://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/basics/risk-factors/con-20034244
http://www.imedicure.com/hometopics/erectile-dysfunction/
http://www.urologyhealth.org/urology/index.cfm?article=60