Erectile Dysfunction Case Study

GENERAL

Men with diabetes are prone to erectile dysfunction

Among 35 to 75 % of people suffering from ED have been diagnosed with diabetes

Erectile dysfunction is commonly caused due to progression of age in normal males but it occurs 10 - 15 years earlier in men with diabetes

Normal erectile function occurs on the basis of various mechanisms such as: *desire for his sexual partner (libido) *proper circulation of blood from iliac artery into corpora cavernosa for erection and penile rigidity *proper discharge of sperm and seminal fluid through his urethra

A person is diagnosed with ED if he is unable to achieve or sustain an erection for sexual intercourse

CLASSIFICATION

Male Erectile Dysfunction is broadly classified into two categories :

Common risk factors associated with arteriogenic dysfunction include diabetes mellitus , pelvic trauma , hypertension , nicotine and hyperlipidemia. Long distance cycling has been found to be a risk factor for vasculogenic and neurogenic erectile dysfunction.

In some reports , diabetic men have been seen to have a greater incidence of fibrotic lesions of cavernous artery with intimal proliferation , calcification and luminal stenosis. Smoking tobacco or other forms of nicotine based products affects erectile function by retarding the arterial flow to the penis and also blocks relaxation of corporeal smooth muscle relaxation. This results in the prevention of normal venous occlusion.

Neuronal- and endothelial-derived nitric oxide are the principal mediators of corporal smooth muscles. Impairments in neurogenic and endothelium-dependant corporal smooth muscle relaxation is observed in the case of diabetes mellitus and is responsible for erectile dysfunction in diabetic patients

At early stages of diabetes , before the patient is aware of underlying diagnosis and high blood glucose levels there are two very important factors that trigger events which lead to complications such as erectile dysfunction . the factors are high blood glucose and low insulin . low insulin concentration in type 1 diabetes and low insulin action due to receptor resistance in type 2.

Effect of high glucose on endothelial nitrogen oxide (NO) dependant vasodilation has been researched, using isolated human blood vessels , high glucose concentrations have been shown to have varying effects on endothelial nitrogen oxide – dependant relaxations depending on the type of vascular bed.

Reason for glucose induced vasodilation is due to increased insulin levels as a direct response to glucose insulin is known to elicit vasodilation