KINE 2475 Lecture Notes - Lecture 33: Hypoactive Sexual Desire Disorder, Erectile Dysfunction, Beta Blocker

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Patient concern & chief complaint: ed: inability to achieve or maintain an erection of sufficient rigidity to allow for satisfactory sexual activity for at least 3 month. Organic ed: vascular: compromised vascular flow to corpora cavernosum (hypertension, vascular disease, atherosclerosis, neurological: impaired nerve conduction to brain (spinal cord injury, stroke) or periphery (diabetes, hormonal: disease caused by hypogonadism results in low testosterone and secondary ed. Psychogenic ed- no psychogenic stimuli: malaise, reactive depression, performance anxiety, alzheimers disease, hypothyroidism. Drug therapy problem: patient is experiencing ed and requires initiation of drug therapy, patient is experiencing ed secondary to hypertension, hyperlipidemia and age related endothelial damage. Insomnia: psychological factors: depression, anxiety, advanced age- low testosterone >70 years, diabetes: 3x risk, heart disease: 4x risk, hypertension: 1. 5x risk, high blood pressure, elevated cholesterol, diabetes, neurologic disease- pelvic surgery trauma, alcohol. Injection: alprostadil by urethral instillation, vacuum erection devices (veds): creates vacuum to draw venous blood into penis.

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