Vasculogenic erectile dysfunction

Erectile dysfunction Treatment of erectile dysfunction caused by neurogenic, vasculogenic, psychogenic, or mixed etiology. 

Erectile dysfunction of vasculogenic, psychogenic, or mixed etiology - Do not give more than 2 doses within a 24-hour period during initial titration. If there is no response to the initial 2.5 meg dose, the second dose may be increased to 7.5 meg within 1 hour. If additional titration is required, doses in increments of 5 to 10 meg may be given at least 24 hours apart. 

A higher percentage of patients with psychogenic and neurogenic erectile dysfunction responded to alprostadil and at a lower dose when compared to patients with vasculogenic erectile dysfunction. 

The main source of blood supply to the penis (Fig. 2.2a) is usually through the internal pudendal artery, a branch of the internal iliac artery. In many instances, however, accessory arteries arise from the external iliac, obturator, vesical, and/or femoral arteries, and may occasionally become the dominant or only arterial supply to the corpus cavernosum (Breza et al. 1989). Damage to these accessory arteries during radical prostatectomy or cystectomy may result in vasculogenic erectile dysfunction (ED) after surgery (Aboseif et al. 1994 Kim et al. 1994). 

Sarteschi LM, Montorsi F, Fabris FM et al (1998) Cavernous arterial and arteriolar circulation in patients with erectile dysfunction a power Doppler study. J Urol 159 428-432 Shabsigh R, Fishman IJ, Quesada ET et al (1989) Evaluation of vasculogenic erectile impotence using penile duplex ultrasonography. J Urol 142 1469-1474 Tam PY, Keller T, Poppiti R et al (1998) Hemodynamic effects of transurethral alprostadil measured by color duplex ultrasonography in men with erectile dysfunction. J Urol 160 1321-1324... 

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