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Case Study Analysis-Erectile Dysfunction

Case Study Analysis-Erectile Dysfunction

Erectile dysfunction is a common sexual dysfunction in males and is always associated with reduced quality of life of the patients and their partners. It is defined as the inability to get and maintain a hard erection that is firm enough for sexual intercourse. Penile erection is a neurovascular process that requires vasodilation, relaxation of the smooth muscles, increased vascular blood flow, and a normal veno-occlusive function. The prevalence of ED is 5% and 10% among men in their 40s and 50s, respectively. The risk factors for ED are, aging, obesity, depression, lack of exercise, diabetes, cardiovascular diseases, benign prostate hyperplasia, and lower urinary tract symptoms (Jenkins, L et al., 2016).

The Factors that Affect Fertility (Stds)

Infertility is a common and severe consequence of STDs, and it is mainly caused by pelvic inflammatory disease (PID). This condition is most common if the cause of PID is other microorganisms other than gonococci. Infertility can be affected by the following factors, age and tubular infection (Ross J. et al., 2018).

Why Inflammatory Markers Rise in STD/PID

Pelvic inflammatory disease (PID) is among the most regular infections in sexually active women and is a serious complication of gonorrhea and chlamydia. It is always caused by the colonization of the endo-cervix by microorganisms. After the colonization, the microorganisms then ascend into the endometrium and the oviduct. This triggers an inflammatory response along any part of the endometritis, salpingitis, and peritonitis (Pirola, G. M. et al., 2019). The polymicrobial course of the PID can be traced into an STI that colonizes the upper genital tract, including; trachomatis, chlamydia, and Neisseria gonorrhea. The common bacteria that cause sexually transmitted infections is chlamydia. This is a gram-negative bacteria, and it usually infects the epithelial lining of the cervix, urethra, and uterus.

PID is always correlated with high levels of inflammatory markers, for instance, CA – 125, ECR, and CRP. The increase in inflammatory markers in the serum can be attributed to the following reason. The increased endometriosis CA – 125 levels can be associated with inflammatory reactions in the peritoneum mesothelial cells and endometriosis cyst leakage into the perineum. CA-125 antigens are normally found on the epithelial cells of an adult’s oviduct, suggesting that acute inflammation of the fallopian tube can result in an increase in the concentration of serum CA-125 (Park et al., 2017).

Prostatitis and Infection  and the Causes of Systemic Reaction

Prostatitis is thought to be associated with ascending infection of the urethra or leakage of infected urine into the prostatic ducts. It is commonly caused by Escherichia coli. It is an infection of the prostate gland and comprises dysuria, with obstructive urinary symptoms (Hedayat, Lapraz & Schuff, 2020). The cause of systemic reaction in prostatitis is the occasional direct spread of the infection through the lymphatic system or hematogenous spread.

Why a Patient Would Need a Splenectomy after a Diagnosis of ITP

In people with PID, the production of platelets is usually suppressed and characterized by autoimmune destruction of the circulating platelets. In this condition, the immune system often recognizes the platelets as foreign organisms, destroying them. This process is always mediated by the spleen. Splenectomy is the surgical removal of the spleen that targets the platelets clearance sites and autoantibody production. Therefore, this procedure helps increase the circulation of platelets in the blood for patients with PID. This procedure is therapy for dependent immune thrombocytopenia (Misiakos, E. P et al., 2017)

In conclusion, ED is a common problem that affects sexual function in men. Most incidences of this condition are related to age, with conditions such as hypertension, diabetes, depression, and hypogonadism being risk factors for ED. A proper physical examination and laboratory investigation are mandatory in the diagnosis of this condition. Depression and hypogonadism are also risk factors for ED. A proper physical examination and laboratory investigation are mandatory in the diagnosis of the condition.

References

Hedayat, K., Lapraz, J., & Schuff, B. (2020). Prostate enlargement with lower urinary tract obstruction (LUTO). The Theory Of Endobiogeny, 249-258. doi: 10.1016/b978-0-12-816965-0.00038-x

Misiakos, E. P., Bagias, G., Liakakos, T., & Machairas, A. (2017). Laparoscopic splenectomy: Current concepts. World journal of gastrointestinal endoscopy9(9), 428.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605342/

Park, S., Lee, S., Kim, M., Kang, Y., Moon, H., & Rhim, C. (2017). Clinical characteristics of genital chlamydia infection in pelvic inflammatory disease. BMC Women’s Health, 17(1). doi: 10.1186/s12905-016-0356-9

Pirola, G. M., Verdacchi, T., Rosadi, S., Annino, F., & De Angelis, M. (2019). Chronic prostatitis: current treatment options. Research and reports in urology11, 165. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6556531/

Ross, J., Guaschino, S., Cusini, M., & Jensen, J. (2018). 2017 European guideline for the management of pelvic inflammatory disease. International journal of STD & AIDS29(2), 108-114. https://journals.sagepub.com/doi/abs/10.1177/0956462417744099

Yafi, F. A., Jenkins, L., Albersen, M., Corona, G., Isidori, A. M., Goldfarb, S. & Hellstrom, W. J. (2016). Erectile dysfunction. Nature reviews Disease primers2(1), 1-20. https://www.nature.com/articles/nrdp20163

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Question 


Case Study Analysis-Erectile Dysfunction

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.

42-year-old man presents to ED with 2-day history of dysuria, low back pain, inability to fully empty his bladder, severe perineal pain along with fevers and chills. He says the pain is worse when he stands up and is somewhat relieved when he lies down. Vital signs T 104.0 F, pulse 138, respirations 24. PaO2 96% on room air. Digital rectal exam (DRE) reveals the prostate to be enlarged, extremely tender, swollen, and warm to touch.

In your Case Study Analysis related to the scenario provided, explain the following as it applies to the scenario you were provided (not all may apply to each scenario):

  • The factors that affect fertility (STDs).

    Case Study Analysis-Erectile Dysfunction

    Case Study Analysis-Erectile Dysfunction

  • Why inflammatory markers rise in STD/PID.
  • Why prostatitis and infection happens. Also explain the causes of systemic reaction.
  • Why a patient would need a splenectomy after a diagnosis of ITP.

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