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Section: Erectile Dysfunction (list 2)
Clinical Tests Used to Diagnose ED
Duplex ultrasound (Duplex ultrasound is used to evaluate blood flow, venous leak, signs of atherosclerosis, and scarring or calcification of erectile tissue. Injecting prostaglandin, a hormone-like stimulator produced in the body, induces erection. Ultrasound is then used to see vascular dilation and measure penile blood ...Section: Erectile Dysfunction
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Oral treatment
The cyclic nucleotide phosphodiesterases constitute a group of enzymes that catalyse the hydrolysis of the cyclic nucleotides cyclic AMP and cyclic GMP. They exist in different molecular forms and are unevenly distributed throughout the body. One of the forms of phophodiesterase is termed PDE5. The prescription PDE5 inhibitors sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) ...Section: Erectile Dysfunction
Pathophysiology
Penile erection is managed by two different mechanisms. The first one is the reflex erection, which is achieved by directly touching the penile shaft. The second is the psychogenic erection, which is achieved by erotic or emotional stimuli. The former uses the peripheral nerves and the lower parts of the spinal cord, whereas the latter uses the limbic system of the brain. In both conditions, an intact neural system is required for a successful and complete erection. Stimulation of penile shaft by the nervous system leads to the secretion of nitric oxide (NO), which ...Section: Erectile Dysfunction
Alprostadil
Alprostadil can be injected into the penis or inserted using a special applicator - usually just before sexual intercourse. Alprostadil has also become available in some countries as a topical cream (under the brand name Befar), and preliminary studies have shown a clinical efficacy of up to 83%. It has an onset of action of 10-15 minutes and its effects can last over 4 hours.Section: Erectile Dysfunction