Erectile%20dysfunction Signs and Symptoms

Signs and Symptoms

Definition

Inability to attain and maintain an erection enough to have satisfactory sexual performance for at least 3 months

Etiology

Increasing evidence have shown that erectile dysfunction can be an early manifestation of coronary artery and peripheral vascular disease

Signs and Symptoms

Complete loss of penile rigidity is uncommon
A patient may complain of partial erection that could not attain vaginal penetration
Initial penile erections can penetrate but early detumescence occurs without ejaculation
Nocturnal penile tumescence
Inability to maintain erection during private masturbation and/or erections related to erotic materials or other partners

Risk Factors

Erectile dysfunction has common risk factors as with cardiovascular diseases
Studies have shown that erectile dysfunction has been associated with lower urinary tract symptoms, benign prostatic hyperplasia, and sexual dysfunction, regardless of age and other comorbidities and various lifestyle factors

Comorbidities and other risk factors that may contribute to erectile dysfunction:
Arteriogenic

Diabetes mellitus
Hypertension
Cardiovascular disease
Hyperlipidemia and the metabolic syndrome
Heavy smoking
Peripheral vascular disorders
Recreational drug abuse

Neurogenic

Trauma
Spinal cord injury

Endocrine

Diabetes mellitus
Hypogonadism/testosterone deficiency
Hyperprolactinemia
Hyper- and hypothyroidism
Obesity

Psychiatric and Psychogenic

Depression
Anxiety disorders
Relationship issues
Stress
Performance anxiety
Loss of attraction

Drugs

Antiandrogens (eg Finasteride)
Antihypertensives (beta-blockers, Spironolactone, Methyldopa, thiazide diuretics)
Narcotics
Cimetidine
Antidepressants
Tranquillizers
Others (eg Clonidine, Guanethidine and Ketoconazole)

Penile Disorders

Peyronie’s disease
Severe phimosis

Others

Alcohol abuse
Obstructive sleep apnea
Pelvic and prostatic radiation therapy
Pelvic and prostate surgery [eg transurethral resection of the prostate (TURP), radical prostatectomy]
Sedentary lifestyle

Optimizing metastatic hormone-sensitive prostate cancer treatment in advanced prostate cancer

Assoc Prof. Darren Poon, Assoc Prof. Edmund Chiong, 14 Jan 2021

Metastatic hormone-sensitive prostate cancer (mHSPC) refers to the condition whereby patients have metastatic prostate cancer and no prior hormonal therapy or androgen deprivation therapy (ADT). Typically, patients with mHSPC have been treated with ADT alone, following which, the overwhelming majority develop castration resistance over time and head towards eventual mortality. In recent years, the publication of various landmark trials has prompted dramatic changes in the mHSPC treatment landscape, and had favourably impacted overall survival (OS) in these patients. At a recent webinar, A/Prof Darren Poon, Honorary Consultant in Clinical Oncology, Hong Kong Sanatorium & Hospital, and Honorary Clinical Associate Professor, Department of Clinical Oncology, The Chinese University of Hong Kong, reviewed treatment options in mHSPC, while A/Prof Edmund Chiong, Head and Senior Consultant, Department of Urology, National University Hospital, Singapore, presented a case which was discussed by an esteemed panel of experts. This webinar was jointly organized by the Singapore Society of Oncology and the Singapore Urological Association, and supported by Astellas.