NEUROLOGIC ERECTILE DYSFUNCTION - 03/09/11
Resumen |
Neurologic erectile dysfunction can be defined broadly as an inability to sustain or maintain a penile erection owing to neurologic impairment or dysfunction.125, 166 The traditional clinical classifications of erectile dysfunction include vasculogenic (organic), psychogenic, neurogenic, and endocrinologic disease. Unfortunately, such clear designations are less defined in actual practice with mixed etiologies of disease. Neurologic erectile dysfunction can overlap vasculogenic (organic), endocrinologic, or psychogenic erectile dysfunction secondary to unrelated disorders resulting in peripheral neuropathies, nerve damage, or traumatic loss of neural function. Underlying etiologies can include diabetes, multiple sclerosis, Parkinson's disease, hereditary peripheral neuropathies, spina bifida, radical retropubic prostatectomy, spinal cord injury, and lumbar disk herniation. Each of these conditions presents with its own set of unique and confounding pathophysiologies.
The physiology of erectile dysfunction has been explored over the past 25 years from a peripheral penile smooth muscle perspective,10 whereas the contributions of the central and peripheral nervous system to penile erection are less well defined. Following a brief review of neurophysiology, the etiologies of disease, diagnosis, and office work-up and treatment of neurologic erectile dysfunction are discussed herein. Prospectives for future research and treatment strategies are explored.
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| Address reprint requests to Ajay Nehra, MD, Department of Urology, Mayo Medical School, Mayo Clinic 200 First Street SW, Rochester, MN 55905, e-mail: nehra.ajay@mayo.edu |
Vol 28 - N° 2
P. 289-308 - mai 2001 Regresar al númeroBienvenido a EM-consulte, la referencia de los profesionales de la salud.
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