Erectile Dysfunction - B. Pharma 2nd Semester Pathophysiology notes pdf

Erectile Dysfunction

Content

• Erectile Dysfunction
• Definition
•  Causes
•  Pathophysiology
• Clinical Features

Objectives

At the end of this PDF Notes, students will be able to –

•       Define Erectile dysfunction

•       Explain the Pathophysiology of ED

•       Describe the clinical features of ED

Erectile Dysfunction (ED)

Erectile dysfunction is defined as “the failure to achieve a penile erection to allow for satisfactory sexual intercourse”

Patients may refer to it as impotence

Main Causes of Erectile dysfunction

Etiology of Erectile dysfunction

•       Psychogenic

•       Vasculogenic : - Cardiovascular disease - Hypertension - Diabetes mellitus - Major surgery or radiotherapy (pelvis or etroperitoneum).

•       Neurogenic Central causes - Multiple sclerosis - Parkinson’s disease - Tumors - Stroke - Spinal cord disorders( disc disease ) Peripheral causes - Diabetes mellitus - Alcoholism - Polyneuropathy - Surgery (pelvis or retroperitoneum).

•       Anatomical / structural - Peyronie’s disease - Penile fracture - Congenital curvature of the penis

•       Hormonal - Hypogonadism - Hyperprolactinemia - Hyper-and hypothyroidism - Cushing's disease.

•       Drug-induced - Antihypertensives (beta-blocker,thiazide and clonidine .less with ACE inhibitors ) - Antidepressants (tricyclic antidepressants and MAO inihibitor) - Antipsychotics - Antiandrogens - Antihistamines - Recreational drugs (Heroin and cocaine)

How Dose Erection Normally Happen?

Process of Erection

Pathophysiology of Erectile Dysfunction

•       Any single abnormality or combination of abnormalities of the four systems necessary for a normal penile erection

•       Vascular, neurologic, or hormonal etiologies of erectile dysfunction are collectively referred to as organic erectile dysfunction

•       Patients who do not respond to psychogenic stimuli have psychogenic erectile dysfunction

•       Diseases that compromise vascular flow to the corpora cavernosum (e.g., peripheral vascular disease, arteriosclerosis, and essential hypertension) increases incidence of ED

•       Diseases that impair nerve conduction to the brain (e.g., spinal cord injury or stroke) or conditions that impair peripheral nerve conduction to the penile vasculature

•       Diseases associated with hypogonadism, primary or secondary, result in subphysiologic levels of testosterone, which cause diminished sexual drive (decreased libido) and secondary erectile dysfunction

•       Vasoconstrictor effect of cigarette smoking may compromise blood flow to the corpora and decrease cavernosal filling

•       Excessive ethanol intake may lead to androgen deficiency, peripheral neuropathy

Clinical Presentation of Erectile Dysfunction

Summary

•       Erectile dysfunction is defined as “the failure to achieve a penile erection to allow for satisfactory sexual intercourse”

•       It can occur due to various causes like psychogenic, vasculogenic and neurogenic

•       Failure to initiate psychogenic or neurogenic impulse or failure to increase arterial blood pressure may result in ED

•       ED may ultimately lead to impotence