Impotence
Definition
Types:
Aetiology
Clinical Features
Symptoms
Signs
Management
Source
Dr Paul Hanson 2014
Dr Michael Monsour 2014
Types:
- Premature
- Retrograde (congen - spina bifida, bladder neck; acquired - diabetes, MS)
- Anejaculation (no semen, no expulsion)
Aetiology
- Diabetes Mellitus (most common)
- THC (common)
- HTN
- Smoking
- Low testosterone levels
- Hyperprolactaenemia
- Post radical prostatectomy
Clinical Features
Symptoms
- Morning stiffness (if present, most likely psychological - anxiety/ relationship/ confidence)
- CVD risks (it's a vascular organ after all)
Signs
- Penis
- Testes
- Prostate
Management
- Premature: EMLA, fluoxetine/ paroxetine, counselling (effective only with partner)
- Phosphodiesterase (PDE5) inhibitors: Sidenafil (Viagra), Tadalafil (Levitra), Vardenafil (Cialis)
- Injection (Caverjet Impulse) to ++ blood flow
- External device (Vacuum pump + ring)
- Penile prostheses
- Semi-rigid implants
Source
Dr Paul Hanson 2014
Dr Michael Monsour 2014