Erectile tissue

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II. Physiologic Characteristics of Erectile Tissues

  • List the functional changes in penile arterial blood flow, cavernosal contractility and venous outflow during the processes of erection and detumescence
  • List the important neurotransmitters and their mechanisms of action in mediating erection and detumescence
  • Explain the role of testosterone in achieving and maintaining penile erection
  • Utilizing the knowledge acquired in points A and C above, explain the physiologic basis of erectile dysfunction in situations of stress, diabetes mellitus, and hypertension, and smoking
  • Utilizing the knowledge acquired in points A and C above, explain the physiologic basis of selected physician interventions in erectile dysfunction, for example Viagra, arginine, Yohirnbine, PGE, various vacuum or other mechanical devices

Penis

During erection, penile arterial blood flow increases by vasodialation, while venous outflow is decreased due to muscular contraction and vasoconstriction. Detumescence is instead the opposite: vasoconstriction of the arteries occurs, and vasodialation of the veins. Failure of these mechanisms at any stage can result in sexual dysfunction.

Neurotransmitters

It was previously thought that vascular tone of the penis was controlled by excitatory and inhibitory autonomic nervous system components. This assessment was later discovered to be overly simplistic and, consequently, wrong. Instead, several neurotransmitters seem to be involved, including:


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