Erectile%20dysfunction Signs and Symptoms

Signs and Symptoms

Definition

Inability to attain & 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 & 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 w/ cardiovascular diseases
Studies have shown that erectile dysfunction has been associated w/ lower urinary tract symptoms, benign prostatic hyperplasia, & sexual dysfunction regardless of age & other comorbidities & various lifestyle factors

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

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

Neurogenic

Trauma
Spinal cord injury

Endocrine

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

Psychiatric & 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

Penile Disorders

Peyronie’s disease
Severe phimosis

Others

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

Spotlight on multidrug-resistant gram-negative infections: New developments for an old problem

Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021

Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.