SHAHRYAR COHANZAD MD SexUrologist PARS HOSPITAL Tehran Iran

PREVALENCE • 52% 40 -70 YEARS OF AGE • 10 MILLION AMERICAN MEN COMPANY

MALE SEXUAL FUNCTION DEPENDS ON AN INTACT: • • • 1 -NERVOUS SYSTEM 2

DEFINITION Lack of ability to achieve or maintain erection with sufficient rigidity for completing

PENILE VASCULATURE ARTERIAL COMPONENT • Internal Iliac Artery • Internal Pudendal Artery A- Pelvic

VENOUS VASCULAURE COMPONENT • Superfacial Plexus/ drains to Saphenous Vein • Intermediate Plexus/ Periprostetic

GENERAL QUOT • ERECTION IS A PURE PARASYMPATHETIC EVENT • EJACULATION IS TOTALLY SYPATHETIC

HORMONES OTHER THAN TESTOSTERONE ESTROGEN etc… • 1 -VIP-VASOACTIVE INTESTINAL PRPTIDE • 2 -ENDOTHELIAL

VENO-OCCLUSIVE MECHANISM • ANATOMICAL-FUNCTIONAL APPARATUS • NOBLE- PRIZE-WINNING DISCOVERY • INTRA-CAVERNOSAL PRESURE INCREASE WITHOUT

NITRIC OXIDE • NO RELEASE LEADS TO AN INCREASE TO c. GMP (VIP, EDRF&

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SHAHRYAR COHANZAD, MD Sex-Urologist PARS HOSPITAL Tehran -Iran Company LOGO

MALE SEXUAL DYSFUNCTION COMPANY LOGO

PREVALENCE • 52% 40 -70 YEARS OF AGE • 10 MILLION AMERICAN MEN COMPANY LOGO

MALE SEXUAL FUNCTION DEPENDS ON AN INTACT: • • • 1 -NERVOUS SYSTEM 2 -CARDIOVASCULAR SYSTEM 3 -ENDOCRINOLOGICAL SYSTEM 4 -GENITAL &REPRODUCTIVE SYSTEM 5 -PSYCHOLOGIC-PERSONALITY SYSTEM COMPANY LOGO

DEFINITION Lack of ability to achieve or maintain erection with sufficient rigidity for completing a satisfactory sexual life COMPANY LOGO

PENILE VASCULATURE ARTERIAL COMPONENT • Internal Iliac Artery • Internal Pudendal Artery A- Pelvic B- Ischiorectal C- Gluteal D-Perineal COMPANY LOGO

VENOUS VASCULAURE COMPONENT • Superfacial Plexus/ drains to Saphenous Vein • Intermediate Plexus/ Periprostetic plexus • Deep Plexus / Internal Iliac COMPANY LOGO

ANATOMY OF ERECTIN & DETUMESCENCE COMPANY LOGO

PENILE VASCULATURE VENOUS COMPONENT COMPANY LOGO

INNERVATION COMPANY LOGO

VEO-OCCLUSIVE MECHANISM COMPANY LOGO

GENERAL QUOT • ERECTION IS A PURE PARASYMPATHETIC EVENT • EJACULATION IS TOTALLY SYPATHETIC IN ORIGIN COMPANY LOGO

HORMONES OTHER THAN TESTOSTERONE ESTROGEN etc… • 1 -VIP-VASOACTIVE INTESTINAL PRPTIDE • 2 -ENDOTHELIAL DERIVED RELEASING FACTOR • 3 - PROSTAGLANDINS(PGE 1/PGF 2 -Alpha) COMPANY LOGO

MECHANISM ICVR Decrease Many-fold increase in AS Venoocclusive mechanism COMPANY LOGO

VENO-OCCLUSIVE MECHANISM • ANATOMICAL-FUNCTIONAL APPARATUS • NOBLE- PRIZE-WINNING DISCOVERY • INTRA-CAVERNOSAL PRESURE INCREASE WITHOUT ELEVATION IN SYSTEMIC BLOOD PRESURE (TOM-FLUE) • SMOOTH MUSCLE RELAXATION PRECEDED BY NITRIC OXIDE RELEASE COMPANY LOGO

NITRIC OXIDE • NO RELEASE LEADS TO AN INCREASE TO c. GMP (VIP, EDRF& etc) GIVING RISE TO SMOOTH MUSCLE RELAXATION COMPANY LOGO

ULTIMATE GAIN • AFFERENT COMPONENT PREDOMINANCE UPON EFFERENT COUNTERPART COMPANY LOGO

ETIOLOGY AT A GLANCE COMPANY LOGO

THE ROLE OF DOPAMONE, OXITOCIN & NITRIC OXIDE COMPANY LOGO

INCRIMINATED DRUGS COMPANY LOGO

ORGANIC CAUSES OF DISEASE RELATED ED COMPANY LOGO

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