By Roger S. Kirby
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Additional info for An Atlas of Erectile Dysfunction, Second Edition (Encyclopedia of Visual Medicine)
VASCULOGENIC CAUSES Arterial insufficiency Because the development and maintenance of a rigid erection depend on achieving a high intracavernosal pressure, it is not surprising that disorders affecting the peripheral arterial blood flow are strongly associated with erectile dysfunction (Table 2). The most common cause is atheroma involving either the common or internal iliac arteries or their more distal branches (Figure 28). The risk factors for this are similar to those for coronary artery disease (including smoking, hypertension, hyperlipidemia, diabetes mellitus and obesity).
1-Adrenoceptor antagonists are potent vasodilators and, as such; would be expected to enhance erectile response. Recent data from its use in men with symptomatic hypertension (approximately one-third of whom complain of some erectile dysfunction) suggest a mild beneficial effect with several of these compounds on sexual function as well as high blood pressure-related symptoms. In contrast, other antihypertensive agents; especially β-blockers and diuretics, were associated with a significant incidence of erectile dysfunction (Figure 54).
G. alcoholism, liver failure) Page 23 Table 5 Age-related pathophysiology of organic erectile dysfunction Cellular senescence alters collagen content in corpora cavernosa/tunica albuginea, leading to venous occlusive dysfunction/decreased neuronal transmission to cavernosal smooth muscle Aging alters endothelial function, leading to decreased basal nitric oxide release and up-regulation of basal endothelin-1 Reproductive aging in animals impairs neurogenic erectile response: increase in latency period to attain an erection/decrease in maximal intracavernosal pressure; loss of function integrity of endoluminal structures; imbalance in expression of vasoconstricting/vasorelaxing modulators of penile erection/decrease in nitric oxide synthase/increase in endothelin-1 levels PRIAPISM AND POSTPRIAPISM ERECTILE DYSFUNCTION Priapism may be defined as an involuntary erection that lasts for more than 4–6 h.
An Atlas of Erectile Dysfunction, Second Edition (Encyclopedia of Visual Medicine) by Roger S. Kirby