![]() ![]() His physical examination is unremarkable except for diminished peripheral pulses, and he appears to be in good spirits.Īn erection is initiated by the parasympathetic division of the autonomous nervous system and is accomplished by engorgement of corpora cavernosa with venous blood in response to various physiological stimuli, resulting in hardening, swelling, and enlargement of the penis as a prelude to sexual intercourse. ![]() He is taking the following medications: enalapril aspirin isosorbide mononitrate doxazosin lovastatin and insulin glargine. He has a history of coronary artery disease with a myocardial infarction five years ago, well-controlled hypertension for the last ten years, diabetes mellitus for 15 years, benign prostatic hypertrophy, exertional angina, and hyperlipidemia. The patient currently acts as a consultant to several companies, exercises daily, and is an avid golfer and an active member of his country club. However, he failed to obtain sufficient erection at the moments that mattered. On the insistence of his children and friends, he began to socialize again and recently met an attractive female, with whom he started an intimate relationship. He was depressed initially and often thought of his late wife. ![]() He was married for 30 years when his wife died of cancer three years ago. A 72-year-old male who is a retired CEO of a major company and a long-time patient complains of erectile dysfunction (ED) on a routine office visit. ![]()
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