impotence in diabetics

Etiology: 1) vascular disease 2) neuropathy 3) medications a) antihypertensive agents 1] beta-blockers 2] diuretic agents 3] centrally-acting agents (clonidine) b) tricyclic antidepressants 4) hypogonadism 5) psychogenic Epidemiology: 1) impotence is 3 times more common in diabetic men 2) psychogenic impotence occurs in 10% of diabetic men Management: 1) sildenafil (Viagra) - diabetics are less likely to respond 2) injection of prostaglandin E2 (alprostadil) 3) commercially available mechanical devices a) vacuum to produce an erection b) rubber band to constrict venous return at the base of the penis 4) penile prosthesis - highest rate of complications

General

impotence diabetes mellitus complication

References

Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998