Prof. Dr.Mohamed Hamdy Abouel-Hassan

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Vascular Supply of the Penis 1-Arterial inflow 1. Supplies glans penis and shaft of penis 2. Branches of deep internal Pudendal arteries 2-Venous drainage 1 - Superficial a. Common penile artery b. Bulbar artery c. Dorsal artery d. Urethral artery e. Cavernosal artery penile veins 2 - Superficial dorsal vein 3 - Intermediate penile veins Emissary vein Circumflex vein Deep dorsal vein 3. Deep penile veins a. H b. C ilar avernosal vein (Santorini's Plexus) vein B-Functional Anatomy of the Penis Review of literature The penis is composed of three cylindrical structures, the paired corpus cavernosum and the corpus spongiosum, which houses the urethra, covered by a loose subcutaneous layer and skin. The flaccid length of the penis is controlled by the contractile state of the erectile smooth muscle and varies considerably, owing to emotion and outside temperature. In one study, the erect length of the penis measured from pubopenile junction to the meatus 12
was 8.8 t m Review of literature flaccid, 12.4 cm stretched, and 12.9 cm erect, with' neither a man's age nor the size of the flaccid penis accurately predicting erectile length (W essells et al, 1996). In another study, the author concluded that about 15% of men have a downward curve during erection; erection angle is below horizontal in one fourth of men; and shorter erection lengths in the range of 4.5 to 5.75 inches occur in 40% of men (Sparling, 1997). Regarding penile morphology and erection, a study shows that during erection, the penile buckling forces are dependent not only on I ntracavernosal pressures but also on penile geometry and erectile tissue properties. Therefore, in patients with normal penile homodynamic but without adequate penile rigidity, other structural causes should also be sought (Udelson et al, 1998). The functions of various components of the penis are listed in Table ( ). Table (3): The Function of Penile Components during Penile Erection Component i Function Corpora c avernosa Tunica albuginea (of corpora c muscle Ischiocavernosus avernosa) Smooth muscle Bulbocavernous Supports corpus spongiosum and glans Contains and protects erectile tissue Provides rigidity of the corpora cavemosa Participates in veno-occlusive mechanism Regulates blood flow into and out of the sinusoids Pumps blood distally to speed up erection Provides additional penile rigidity during rigid erection phase muscle Compresses the bulb to help expel semen Corpus spongiosum Provides a pressurized narrow chamber to allow 13
Page 1 and 2: I - ERECTILE DYSFUNCTION - DIAGNOSI
Page 3: INDEX OF CONTENTS Acknowledgment RI
Page 6 and 7: , ist of Abbreviations AVSS Audiovi
Page 8 and 9: SHBG SSR! s U/ S SHIM Sex-Hormone B
Page 10 and 11: Rigiscan, buckles TABLE 18 The resp
Page 12 and 13: Introduction Erectile Dysfunction:
Page 14: Aim of the Study Introduction and A
Page 17 and 18: Review literature o DSM-IV also ask
Page 19 and 20: t P; I -i _10 t / t 0 4 • Review
Page 21 and 22: Review o/ literature Table (1) show
Page 23: 1-1 Male Sexual Anatomy A- Gross an
Page 27 and 28: Review of l Augmenting the septum t
Page 29 and 30: periphery. In the flaccid state, th
Page 31 and 32: whet , , 5'47 , 4 Otra . a■ it ti
Page 33 and 34: Review of literature Hatzichristou
Page 35 and 36: Review of literature 1. Dilatation
Page 37 and 38: Nerves in penis (dorsal penile nerv
Page 39 and 40: Review of literature damaged during
Page 41 and 42: Ischiocavernosus Bulbocavernous Rev
Page 43 and 44: Review of l and A 1 C -adrenergic r
Page 45 and 46: tetrahydrobiop amino acid sequence.
Page 47 and 48: Phosphodiesterase During, the retur
Page 49 and 50: Serotonin Review of literature Raph
Page 51 and 52: Review of literature prolactin's ac
Page 53 and 54: Review of l (Montorsi et al (2002)
Page 55 and 56: Review of literature Mannino and co
Page 57 and 58: arteriogenic most likely related to
Page 59 and 60: veno-occlusive 1991). In animal mod
Page 61 and 62: Revicw of literature fibrosis v and
Page 63 and 64: CHAPTER: 2 Review of literature DIA
Page 65 and 66: • Neurological • Endocrine dise
Page 67 and 68: • Risk factor for atherosclerosis
Page 69 and 70: Review o f literature 2- If either
Page 71 and 72: Interpretation of the results Revie
Page 73 and 74: Review o f literature The basic ass
Page 75 and 76:
Chapter -3 Definitions A-PRIAPISM R
Page 77 and 78:
AUA GUIDE LINE FOR PRIAPISM EVALUAT
Page 79 and 80:
Review of literature blood cells, l
Page 81 and 82:
Review o frog leg position, screeni
Page 83 and 84:
therapeutic aspiration (with or wit
Page 85 and 86:
Al-Ghorab Review of literature Of t
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B- RAPID EJACULATION Review of lite
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Review a ff literature investigatio
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Review of l McCarthy (1998) suggest
Page 93 and 94:
Self Help Techniques ivien Review o
Page 95 and 96:
Corpus c Corpus s ponglosum Tunica
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Clinical Course Review of literatur
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Review of literature perious and in
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CHAPTER: 4 TREATMENT OF ERECTILE DY
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Review of literature interaction is
Page 105 and 106:
Tolerability Review of literature N
Page 107 and 108:
Review of literature Sildenafil and
Page 109 and 110:
Review ( Tadalafil should be used w
Page 111 and 112:
Atter Review of literature sildenaf
Page 113 and 114:
4-Phentolamine, Phentolearnine, Rev
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Revieiv of literature used for test
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ased upon the etiology. The e The p
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E-Hormonal treatment Review of lite
Page 121 and 122:
Review of literal lire satisfaction
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Review of literature covers these d
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Indications: Review of literature I
Page 128 and 129:
2--Identification 1-Sexual Health I
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If yes how many packs per day and i
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Patients and Methods C-Liver functi
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Patients and Methods AMS Ambicore i
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In ally patients, ICI of phenylephr
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2-After treatment failure Patients
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Patients and Methods Criteria used
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Patients and Methods fatty) and he
Page 144 and 145:
Peyrone's Disease Patients Patients
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Patients and Methods Treatment resp
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Penile prostheses patients Patients
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Patients and Methods 4-Next full-st
Page 152:
EMLA Table (8) shows the S SRIs, Pa
Page 155 and 156:
Table (9): Shows the ED presentatio
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( 73/ 459) . Low Table (11): , S'ho
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Results ejaculation ,7 with ED Peyr
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RIGISCAN RESULTS From our total 459
Page 163 and 164:
! --, ntfr. stt: m • " • i t t
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of organic disease see table (17) .
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While there was a highly positive (
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Fierq Wsppto it Thirty- nine p pr 7
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Results cm/s (arteriogenic ED) see
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Dr. Frederic J. Levine 25-Feb-1983.
Page 175 and 176:
Results Table (22): Shows the Table
Page 177 and 178:
So , negative buckle test diagnosed
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81% 19% Results AMS 700 3 piece inf
Page 181 and 182:
80 70 60 50 40 30 20 10 testosteron
Page 183 and 184:
Results Regarding to treatments out
Page 185 and 186:
Results Initial therapy failed in a
Page 187 and 188:
Results 3 piece inflatable 700 AMS
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Results Paroxetine and/or Sertralin
Page 192 and 193:
Discussion sexual dysfunction was a
Page 194 and 195:
Both arterial insufficiency and c o
Page 196 and 197:
Discussion Historically, hypogonadi
Page 198 and 199:
Rigiscan testing was more sensitive
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Recently, PSV was found to be a mor
Page 202 and 203:
Discussion erectile function domain
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Discussion A report on 210 patients
Page 206 and 207:
Discussion Implanted inflatable pen
Page 208 and 209:
Discussion infection, but device ex
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epiF Discussion For individuals on
Page 212 and 213:
Discussion corpus spongiosum and co
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Discussion upon logical solutions (
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SUMMARY AND CONCLUSION Conclusion T
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Conclusion Sixty nine men presented
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Conclusion • Sildenafil citrate i
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1114411111311111
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References Anderson KE, Holmquist F
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Bechara A, et al, (1996): Prostagla
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References Broderick G.A & Harkaway
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References Chung W.S., Sohn J.H. &
Page 233 and 234:
References Dinsmore WW, Hodges M, H
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Hind AC, (1984): Cavernosal alpha-b
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J m Gray A, Feldman HA, McKinlay &
Page 239 and 240:
Helistrom Hellstrom Helistrom Helis
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References Jarow J P, Pugh V W, Rou
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Kloner Kloner Kloner RA, Hutter IS
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References c Lin CS, Lau A, Tu R, &
Page 247 and 248:
Melis References McVary KT, Carrier
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Morisaki N, Kawano M. & Koyama N, (
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References Padma-Nathan H, Kaufman
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Piper PJ, (1973): Distribution and
Page 255 and 256:
References Roose S P, Glassman A H,
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References Schramek P, Dorninger W
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Soderdahl References DW, Thrasher'
Page 261 and 262:
Toblli Taylor S, Sutherland GR, G M
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Wagner G& Uhrenholdt A, (1980): Blo
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- Patient's Name No sexual activity
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DEPRESSION INVENTORY Instructions f
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Do you have a high blood pressure?
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1999_L U , t< 11 . 0 ! ; 3 . 1. J "
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0 = & * J i 4 l t 4 4 ) 1 = k p i j
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Prof. Dr.Mohamed Hamdy Abouel-Hassan

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