Dr. Goldstein presented the educational lecture to a small but focused group of people for this sexual medicine information session. The following is a synopsis of his lecture.
Perineal anatomy/sexual physiology
Risk factors for erectile dysfunction include diabetes, obesity, high blood pressure and high cholesterol, all of which can lead to endothelial dysfunction. The endothelium lines all blood vessels. Injury to the endothelium affects blood flow. Conditions that can cause erectile dysfunction are the same as those which can cause endothelial dysfunction.Endothelial injury can be random or focal. Random injury denudes the endothelium allowing cholesterol to get into the walls of blood vessels causing hardening of the arteries. Focal injury is non-denuded; it is atherosclerosis to a specific spot. Where arteries pass next to a bone, they are susceptible to focal injury of the endothelium. Arteries to the penis and clitoris pass through Alcock’s canal with one wall being bone.
