Erectile pathophysiology

Differentiate between organic and psychogenic erectile dysfunction (ED) and describe the etiology and pathophysiology of each. 

From Lee M. Erectile dysfunction. In DiPiro JT, Talbert RL, Yee GC, et al, (eds.) Pharmacotherapy A Pathophysiologic Approach. 6th ed. New York McGraw-Hill 2005 1524, with permission. 

Melman A and Gingell JC.The epidemiology and pathophysiology of erectile dysfunction. J Urol 1999 161 5-11. 

Erectile dysfunction must be distinguished from disorders of libido, ejaculatory disorders, or infertility, which are caused by different pathophysiologic mechanisms and are treated with alternative agents (Table 81-1). A patient may suffer from one or more disorders of sexual dysfunction. For example, an elderly man with primary hypogonadism may suffer from decreased libido and erectile dysfunction. Diagnosis of the type of sexual disorder that a patient has is a key to initiating the most appropriate treatment. 

Medications may cause erectile dysfunction through similar pathophysiologic mechanisms (Table 81-2). Medications are estimated to be responsible for approximately 10% to 25% of cases of erectile dysfunction. An excellent review of medication-induced erectile dysfunction is available. ... 

Saenz de Tejada 1, Moreland RB. Physiology of erection, pathophysiology of impotence and implications of PGEl in the control of collagen synthesis in the corpus cavernosum. In Goldstein I, Lue TF, eds. The Role of Alprostadil in the Diagnosis and Treatment of Erectile Dysfunction. Princeton, Excerpta Medica, 1993 3-16. 

Category ol erectile dysluiu lion Common disorders Pathophysiology... 

Physiology of Penile Erection and Pathophysiology of Erectile Dysfunction... 

Erectile dysfunction is a multi-factorial disorder and a common presentation for several systemic illnesses, particularly vascular ocdusive diseases such as diabetes, arterial hypertension, and atherosclerosis. Few patients consult their dortor, and only a small proportion of them receive treatment Only few doctors take the initiative to discuss the question of their patients sex life (Costa et al. 2005). In fact, the dinician must be familiar with the pathophysiologic mechanisms of erectile dysfunction, its associations with other systemic diseases, the indications for spedalist referral, and the role of specialized testing to diagnose and treat this disorder effectively (Lobo and Nehra 2005). 

In broad terms, priapism may be regarded as an alteration of imbalance between arterial inflow and outflow. Burnett (2003) has recently reviewed the pathophysiology of priapism and suggested derangements in the diverse systems of regulatory control in erectile function. These dysregulatory functions include possible overactivity of the veno-occlusive mechanism, arterial inflow, or neurogenic processes that can affect inflow or outflow. Conversely, the problem may be secondary to malfunction of the normal contractile activities of cavernosal smooth muscle cells. 

Mukherjee GD (1980) The rise of surgery from empiric craft to scientific discipline. Plast Reconstr Surg 65 531 Munarriz RM, Yan QR, A ZN, et al. (1995) Blunt trauma the pathophysiology of hemodynamic injury leading to erectile dysfunction. J Urol 153 1831-1840 Narayana AS, Olney LE, Loening SA, et al. (1982) Carcinoma of the penis analysis of 219 cases. Cancer 49 2185-2191 Newman HF, Reiss H (1982) Method for exposure of cavernous artery. Urology 19 61-62... 

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