The reproductive system
Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella in Essentials of Human Physiology and Pathophysiology for Pharmacy and Allied Health, 2019
Impotence or erectile dysfunction is associated with the inability of obtaining an erection necessary for successful sexual activity. Occasional erectile dysfunction, while stressful, is normal and may be related to daily life issues such as stress or lack of sleep. The majority of men experience some degree of erectile dysfunction as they age. However, the regular occurrence of erectile dysfunction may indicate the presence of an underlying physiologic or psychologic disorder and the patients should seek evaluation and treatment. Physiologic causes of erectile dysfunction may include hypertension, vascular disease, diabetes, obesity, neurologic disorders, sleep disorders, tobacco use, and surgery/treatment for prostate disorders. Psychologic causes of erectile dysfunction may include depression, anxiety and stress. A thorough physical examination with blood work and urinalysis can often identify the most common physiologic causes of erectile dysfunction. There a number of pharmacologic and non-pharmacologic interventions that have demonstrated efficacy in the treatment of erectile dysfunction.
Endocrine Disruptors and Male Sexual Dysfunction
Rajesh K. Naz in Endocrine Disruptors, 2004
Physically ill men, especially if they are cigarette smokers, are six times more likely to be impotent than healthy men. The medical conditions most often associated with impotence, according to the Massachusetts Male Aging Study, are cardiovascular disease, diabetes, hypertension, an untreated ulcer, arthritis, and allergy [1]. It is usually hard to tell whether the medical condition itself is the most important risk factor or the medication being taken for it or a combination of the two. Men who have had coronary bypass surgery or who suffer from myocardial infarction, stroke, or peripheral blood disease most likely have problems with the supply of arterial blood to the penis. Radiation therapy of the pelvic area frequently causes scarring that results in the penile arteries losing their ability to dilate. With age and the ingestion of toxic agents, neurotransmitter levels may be lower, and the sense of touch decreases. The most frequent neurological disorders associated with impotence are prostate surgery, spinal cord injury, multiple sclerosis, and peripheral neuropathy [1]. Also in an obese man, the body elastin is progressively replaced by less elastic collagen. This may affect the framework of the smooth muscle in the penis, although the MMAS found no correlation between overweight (obesity) and impotence. Thus, most of these conditions do alter the endocrine system.
Endocrinology and gonads
Jagdish M. Gupta, John Beveridge in MCQs in Paediatrics, 2020
11.23. Which of the following statements is/are true of penile hypospadias?The chordee is often the major functional disability,The urethral meatus is often very narrow.Urethral sphincter is often deficient.Impotence is present in more than 20% of cases.Neonatal circumcision is absolutely contraindicated.
Post-Radical Prostatectomy Erectile Dysfunction Assessed Using the IIEF-5 Questionnaire – A Systematic Literature Review
Published in International Journal of Sexual Health, 2022
Tomasz Jurys, Bartlomiej Burzynski, Anna Potyka, Andrzej Paradysz
It is estimated that prostate cancer is responsible for almost 650,000 cases of cancer per year in economically developed countries (Jemal et al., 2011). A patient diagnosed with prostate cancer may be eligible for various types of therapy, depending on his clinical condition. Options include active surveillance, watchful waiting, radical prostatectomy, external beam radiotherapy, brachytherapy, and hormone therapy (Chen & Zhao, 2013). The chosen method of treatment will affect the likelihood of occurrence of complications and the quality of life of the patient. In the case of radical prostatectomy, the most common postoperative symptoms are urinary incontinence and erectile dysfunction (Torvinen et al., 2013). As defined in 1992 by the National Institutes of Health (NIH), erectile dysfunction is the inability to achieve and maintain an erection of sufficient strength for intercourse (“Impotence”, 1993). The frequency of dysfunction after radical prostatectomy may depend on the patient’s clinical condition, the level of experience of the operating surgeon, and the chosen methods of prostatectomy and of nerve sparing (of the vasomotor bundles) (Ayyathurai et al., 2008; Barocas et al., 2010; Bianco et al., 2005; Zippe et al., 2006). One of the most frequently used tools to assess erectile dysfunction of various etiologies, including patients after radical prostatectomy, is the International Index of Erectile Function-5 (IIEF-5) questionnaire.
Autonomic dysfunction in a patient with X-linked adrenoleukodystrophy
Published in International Journal of Neuroscience, 2018
Yifan Zhang, Dongmei Guo, Yi Tang
This case was characterized by OH and impotence symptoms, both of that are associated with dysfunction of autonomic nervous system. The COMPASS31 score of this patient was 42, meaning a severe autonomic deficiency [3]. Other potential etiologies of autonomic dysfunction, including diabetic neuropathy and chronic inflammatory demyelinating polyneuritis were excluded with normal laboratory, EEG and NCS tests. Although pathology is the golden standard for amyloidosis, the diagnosis of amyloid neuropathy is unlikely since there was no renal or gastrointestinal tract involvement, or TTR and APOA1 gene mutations in this patient [4]. Autonomic nervous dysfunction was rarely reported in X-ALD patients [5]. This is the second case of X-ALD with autonomic dysfunction. Schulte et al. firstly presented an interesting X-ALD case with significant autonomic neuropathy, and primary axonal degeneration was confirmed with electrophysiology [6].
Sex after amputation: the relationships between sexual functioning, body image, mood and anxiety in persons with a lower limb amputation
Published in Disability and Rehabilitation, 2018
Lorraine Woods, David Hevey, Nicola Ryall, Fiadhnait O’Keeffe
Among sexually active males in the current study, the most common sexual dysfunctions reported were impotence (69%) and premature ejaculation (59%). The levels of dissatisfaction with the quality of one’s sex life reported by males on the sexual activity questionnaire (40%) may reflect the high levels of dysfunction in the group. Moreover, the high levels of dysfunction appear to play a role in avoidance behaviors, as impotence was strongly related to avoidance of sexual activities. The high rates of sexual dysfunction and avoidance behaviors likely contribute to the high rate of infrequency of sexual activities found. This is in line with Hedon’s [19] observations that sexual dysfunction often increases uneasiness, distance, and avoidance, which reduce sexual encounters and increase communication difficulties within the relationship.
Related Knowledge Centers
- Diabetes
- Sexual Dysfunction
- Cardiovascular Disease
- Hypertension
- Dyslipidemia
- Penis
- Erection
- Sexual Activity
- Mental Distress
- Self-Image