![]() ![]() The morphological and vasculogenic changes that could result in ED are amenable to sonographic diagnosis. This ultimately leads to arteriogenic erectile dysfunction. In the elderly also, there is presence of reactive oxygen species (ROS) which causes inflammation of the endothelium hence, predisposition to atherosclerosis of the cavernosal arteries with attendant reduction in blood inflow to the erectile tissues. Endothelial health is greatly maintained by normal plasma concentration of NO, and this is largely depleted with ageing. Reduced Nitric Oxide (NO) production by endothelial tissues of the penis is another contributory factor to ED in the elderly. These changes result in venous leak and ultimately venogenic erectile dysfunction. Induction of vascular smooth muscle by phenyllephrine is reduced particularly in the cavernosum of those above 60 years which ultimately affects the expected expansion of cavernous sinusoids hence, reduction in their compressive effects on the emissary veins against the tunica albuginea. Also, age-related changes are observed in the erectile tissues because α 1- adrenergic receptor subtypes are modulated by ageing. Medical treatment for prostatic enlargement, hypertension and psychosomatic disorders is also known to affect erectile function in view of the effects of the drugs on the endothelial health which ultimately affects dilatation of the cavernosal arteries and fibrosis of the corporal smooth muscles. ĮD is commoner in the older men when compared with the young because of the age-related risk factors such as systemic hypertension, diabetes mellitus, hyperlipidaemia and obesity which are more frequently seen among the aged population. It could arise from neurogenic, vasogenic, hormonal, psychogenic or iatrogenic origin, but vascular causes are the commonest. This categorization of ED with Doppler study is imperative before initiating therapy as treatment protocol for vasogenic ED is aetiologic specific.Įrectile dysfunction (ED) is consistent inability to maintain erectile turgidity required for normal sexual performance. ConclusionĤ7.4% of the patients had vasogenic ED and venogenic ED was more common than arterioegenic ED in the age range considered. None had Peyronie’s disease, penile fracture, penile tumour or mixed arteriogenic and venogenic ED. Arteriogenic ED was found in two patients (10.6%), while venogenic ED was observed in seven patients, which constituted 36.8% of the entire research participants. The age range of the patients was fifty to sixty-six years (mean: 57.4 ± 4.3 years), while the PSV of CA varied between 21.4 and 104.4 cm/s (mean: 46.2 ± 19.2) among the entire patients, between 21.4 and 22.3 cm/s (mean: 21.9 ± 0.7) among patients with arteriogenic ED, and between 25.0 and 74.9 cm/s (mean: 45.0 ± 15.5) among those with venogenic ED. B-mode scan of the penis was done prior to intracavernosal injection of PGE 1, and the spectral waveforms as well as peak systolic velocity (PSV) of the CA were recorded at 5 min interval, from 5 to 50 min post-intracavernosal injection of PGE 1, using angle of insoation ≤ 60°. The penile scan was done before and after intracavernosal injection of 20 µg of Prostaglandin E 1 (PGE 1). Nineteen consecutive patients with clinical diagnosis of erectile dysfunction were evaluated with Doppler ultrasound scan using a high-frequency linear array transducer. The study was conducted from July 2015 to January, 2017 at Federal Medical Centre Abuja. This study was aimed at establishing vasogenic causes among patients being evaluated for ED using Doppler ultrasound as this category of ED is amenable to either medical and/or surgical treatment. ![]() It is either vasogenic, neurogenic, hormonal, cavernosal or psychogenic in origin, but vasogenic causes are the commonest. Endothelial dysfunction and replacement of cavernosal smooth muscles by collagen fibres are common in older men, making them prone to ED. Erectile dysfunction (ED) is common among ageing men because of associated underlying risk factors which are peculiar to this category of patients. ![]()
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