Abstract: |
This chapter focuses on the pathophysiology of erectile dysfunction (ED) and its various treatments. Erectile dysfunction is defined as the consistent inability to obtain and maintain an erection for satisfactory sexual relations. ED is clinically classified in three groups: psychogenic, organic, and mixed. Previously psychogenic ED was believed to be the most common cause of ED. Recently, mixed organic and psychogenic are accepted as the most common. Psychogenic ED is the persistent inability to obtain and/or maintain adequate erection for sufficient sexual intercourse due primarily to psychological or relationship factors. A lot of psychological conditions such as performance anxiety, lack of sexual arousal, major life stress, or depression, can cause or aggravate ED. Diseases involving the brain, spinal cord, and cavernous or pudendal nerves are associated with ED. Hormonal disorders such as hypogonadism may suppress sexual interest and nocturnal erections. The major risk factors of ED are diabetes mellitus, heart disease, hypertension, dyslipidemia, lower urinary tract symptoms (LUTS), and cigarette smoking. Various tests to evaluate ED include physical examination, laboratory tests, vascular testing, and a special test called Nocturnal Penile Tumescence Test. The most commonly used surgical technique for penile revascularization is a bypass from the inferior epigastric artery to the dorsal artery or deep dorsal vein of the penis. © 2010 Elsevier Inc. All rights reserved. |