RT Book, Section
A1 Demeter, Jonathan H.
A1 El-Zawahry, Ahmed
A2 Nazzal, Munier
A2 Blebea, John
A2 Osman, Mohamed F.
SR Print(0)
ID 1200679872
T1 Erectile Dysfunction
T2 Vascular and Endovascular Surgery: Clinical Diagnosis and Management
YR 2024
FD 2024
PB McGraw Hill
PP New York, NY
SN 9781260462715
LK accesssurgery.mhmedical.com/content.aspx?aid=1200679872
RD 2024/04/19
AB Erectile  dysfunction  (ED)  is  a  common  problem  in  men  as  they  age.  Generally  described  as  the  inability  to  acquire  or  sustain  a  penile  erection  that  is  firm  enough  for  satisfactory  sexual  performance.  Over  20%  of  men  may  suffer  from  moderate  to  severe  ED  by  the  age  of  40  years.1  ED  can  be  considered  organic,  psychogenic,  or  mixed.  Organic  ED  is  due  to  physical  defects  either  in  the  relevant  neurologic  or  vascular  anatomy  and  can  result  from  various  etiologies  including  vasculogenic,  neurogenic,  or  hormonal.  Psychogenic  ED  is  resultant  from  various  factors  and  psychologic  conflicts  inhibit  neuropathways  responsible  for  erections  including  anxiety  about  the  sexual  experience,  guilt,  anger,  lack  of  confidence,  depression,  or  psychosis,  among  others.2  A  leading  cause  of  organic  ED  is  from  diabetes  mellitus  with  hyperglycemia  causing  damage  to  the  cavernosal  nerve  and  small  vessel  and  ultimately  neuropathy  and  arteriogenic  insufficiency.3  As  a  marker  for  small  vessel  arteriosclerosis,  ED  is  a  marker  of  vascular  disease  and  will  precede  and  predict  the  development  of  arterial  blood  vessel  disease  in  other  vessels,  classically  coronary  artery  disease.  This  may  occur  months  to  years  prior  to  patients  becoming  symptomatic  from  the  vascular  pathology  in  other  organs.  For  this  reason,  the  American  Urologic  Association  (AUA)  recommends  an  evaluation  for  dyslipidemia,  diabetes,  and  possible  consultation  to  a  cardiologist  in  patients  with  ED  that  is  gradual  in  onset.  A  list  of  risk  factors  mentioned  in  the  AUA  Guidelines  for  ED  is  listed  in  Table  52-1.