Bệnh tiểu đường rối loạn tâm lý Béo phì, ít vận động tháo đường rối loạn nội tiết bệnh mạch máu ngoại vi Thuốc phẫu thuật chấn thương dây cột sống vùng chậu của thuốc lạm dụng | AMBULATORY MEDICINE TABLE . Medical Conditions Associated with ED Condition ExAMPLES CoMM ENTS Psychogenic disorders Performance anxiety depression mental stress. Obesity physical inactivity Diabetes mellitus ED is seen in up to 50 of cases. Peripheral vascular disease Endocrine disorders Hypogonadism hyperprolactinemia thyroid abnormalities. Pelvic surgery Spinal cord injury Drugs of abuse Amphetamines cocaine marijuana alcohol tobacco. Medications Antihypertensives Thiazides p-blockers clonidine methyldopa. Antiandrogens Spironolactone H2 blockers finasteride. Antidepressants TCAs SSRIs. Other Antipsychotics benzodiazepines opiates. Rapid onset of ED suggests psychogenic causes or medication side effects. More gradual onset is associated with medical conditions. Low libido along with ED suggests a psychogenic medication-related or hormonal cause. Empiric therapy is often indicated in the absence of a suspected organic etiology. Oral phosphodiesterase inhibitors sildenafil vardenafil tadalafil are first-line therapy but are contraindicated with nitrates or active cardiac disease can cause hypotension and sudden death . Psychosexual counseling is first-line therapy for psychogenic ED. Second-line therapies include intraurethral alprostadil suppositories vacuum constrictive pumps and penile prostheses. All patients with genital lesions should be screened for syphilis serology . Prostatitis The differential includes acute bacterial prostatitis chronic bacterial prostatitis nonbacterial prostatitis and prostatodynia. See Table for key features of each. Symptoms Exam Presents with irritative voiding symptoms and perineal or suprapubic pain. Acute bacterial prostatitis is notable for the presence of fever and an exquisitely tender prostate. Treatment Table outlines the treatment of prostatitis and prostatodynia. Genital Lesions Table outlines the differential diagnosis and treatment of STIs that present as genital lesions. Figures through .
