Prof. Dr.Mohamed Hamdy Abouel-Hassan

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Component - Glans Tunica Albuginea Der 1-Function expulsion of semen from urethra ) 7 1- 11' / x11. •ti r 1 - : , t : ultte: _ttl . ell l i d 4: 43-r S. C n i rrric . 7 . - A , W rFel Review of literature Acts as a shock absorb cushion to lessen the impact of penis on female organs The tunica affords great flexibility, rigidity, and tissue strength to the penis (Hsu et al, 1992) (Fig.1). The tunical covering of the corpora cavernosa is a bilayered structure with multiple sublayers. Inner-layer bundles support and contain the cavernous tissue and are oriented circularly. Radiating from this inner layer are intracavernosal pillars acting as struts, ka. . . . orpud -{ c a r t Figure (2): shows a transverse section in the penis with three corpora. [From Catalona ins. 1988] tititif r i : ire. V. . tl Hit 17411: i Jr TiC 14
Review of l Augmenting the septum that provides essential support to the erectile tissue. Outer-layer bundles are oriented longitudinally, extending from the glans penis to the proximal crura; they insert into the inferior pubic rami but are absent between the 5- and the 7-o'clock positions. In contrast, the corpus spongiosum lacks an outer layer or intracorporeal struts, ensuring a low- pressure structure during erection. Figure 45-1 Cross section of the penis shows the intracavernous pillars supporting the erectile tissue and the inner circular and outer longitudinal layers of the tunica albuginea. The longitudinal layer is absent between the corpus cavernosum and the spongiosum. (From Lue TF, Akkus E, and Kour NW: Physiology of erectile function and dysfunction. Campbell's Urology Update #12 1994; 1-10.) The tunica is composed of elastic fibers that form an irregular, latticed network on which the collagen fibers rest. The detailed histologic composition of the tunica varies depending on anatomic location and function. Emissary veins run between the inner and the outer layers for a short distance, often piercing the outer bundles in an oblique manner. The cavernous artery and the branches of the dorsal artery that give additional blood supply to the corpus cavernosum, however, take a more direct route and are surrounded by a periarterial soft tissue sheath. The latter structure protects the arteries from occlusion by the tunica albuginea during erection. The outer tunical layer appears to play an additional role in compression of the emissary veins during erection. It also determines, to a large extent, the variability in tunical thickness and strength (Hsu et al, 1992). At the 7- o'clock position, the tunical thickness is 0.8 ± 0.1 mm; at the 9-o'clock position, 1.2 ± 0.2 mm; and at the 11-o'clock position, 2.2 ± 0.4 mm. At the 3-, 5-, and 1-o'clock positions, the measurements are nearly identical in iterature 15
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 and 24: 1-1 Male Sexual Anatomy A- Gross an
Page 25: was 8.8 t m Review of literature fl
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
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Review of literature blood cells, l
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Review o frog leg position, screeni
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therapeutic aspiration (with or wit
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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
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Self Help Techniques ivien Review o
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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
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Tolerability Review of literature N
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Review of literature Sildenafil and
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Review ( Tadalafil should be used w
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Atter Review of literature sildenaf
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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
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Review of literal lire satisfaction
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Review of literature covers these d
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Indications: Review of literature I
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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
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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
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EMLA Table (8) shows the S SRIs, Pa
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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
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! --, 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.
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Results Table (22): Shows the Table
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So , negative buckle test diagnosed
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81% 19% Results AMS 700 3 piece inf
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80 70 60 50 40 30 20 10 testosteron
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Results Regarding to treatments out
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Results Initial therapy failed in a
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Results 3 piece inflatable 700 AMS
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Results Paroxetine and/or Sertralin
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Discussion sexual dysfunction was a
Page 194 and 195:
Both arterial insufficiency and c o
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Discussion Historically, hypogonadi
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Rigiscan testing was more sensitive
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Recently, PSV was found to be a mor
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Discussion erectile function domain
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Discussion A report on 210 patients
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Discussion Implanted inflatable pen
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Discussion infection, but device ex
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epiF Discussion For individuals on
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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. &
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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 &
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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
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References Roose S P, Glassman A H,
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References Schramek P, Dorninger W
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Soderdahl References DW, Thrasher'
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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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