Erectile dysfunction: Description
Erectile dysfunction (also impotence or abbreviated – ED) is violation of sexual function in men. With age, risk of ED increases, while the main role is played by organic causes. In some cases, development of symptoms can also cause psychological problems, such as depression, state of fear – especially for young men. Often, erectile dysfunction is a consequence of arteriosclerosis and thus indicates risk of blood stroke or myocardial infarction in men over 50 years of age. After diagnosis of ED is established, patient is advised to immediately consult therapist and cardiologist.
Erectile Dysfunction: Symptoms
From medical point of view, erectile dysfunction can be called a condition when a man for more than 6 months with multiple attempts failed to achieve required erection for coitus or keep it before ejaculation. In other words: when male penis does not reach necessary state of erection or quickly loses it.
Temporary, sudden or isolated cases of sexual insolvency should not be considered a violation requiring therapy.
Erectile Dysfunction: Causes and Risks
Most cases of erectile dysfunction is caused by age-related organic changes in the body of a man. So, along with diabetes mellitus, multiple sclerosis, Parkinson’s disease, you can include increased blood pressure (hypertension), damage to cavernous bodies, long-term use of alcohol and nicotine. In addition, problems with erection can be caused by overweight, coronarycalcinosis, sedentary lifestyle and malnutrition. Negative effects on man’s potency are caused by disorders of musculoskeletal system (e. g., prolapse of intervertebral discs, damage to spinal cord, blockade in lumbar region), as well as effects of medications (psychotropic drugs, beta-blockers, antiandrogenic drugs).
Male sex hormone testosterone, above all, plays a role in emergence of sexual desire (libido). Lack of this hormone in the body of a man (hypogonadism) for a long time can also lead to problems with erection.
Erectile Dysfunction: Examination and Diagnosis
To find out causes of sexual disorder, anamnesis is initially collected by urologist, which must necessarily include anamnesis of all adverse events related to risk factors and medications taken by patient. After physical examination of the patient by means of ultrasound, possible mechanical damages can be established. Blood test indicates hormonal disorders (for example, testosterone deficiency) and metabolic problems (for example, diabetes mellitus).
In special cases, injection in cavernous bodies (SKIT) is performed, using pharmaco-duplex sonography of penis. In this case, in cavernous bodies of penis with a thin needle is dilating vascular medication is injected, then in color ultrasound, blood supply of arteries of penis is measured. Only in rare cases there are indications for selective angiography of arteries of penis or for x-ray image of cavernous bodies (cavernosonography).
Erectile Dysfunction: Treatment
In absence of contraindications in treatment of ED most often medicines are used. The most important substance, according to medical specialists, is phosphodiesterase of the 5th group inhibitor (PDE-5 inhibitor, for example sildenafil, tadalafil, vardenafil or avanafil). These drugs differ in time of action and period of onset of their effect after administration. The drugs restrain their own enzyme PDE-5, responsible for reduction of neurotransmitter, which the body intensively produces at sexual excitement and which causes increased blood circulation in penis.
Another method of treatment is the so-called SKAT-therapy (auto-injection therapy of cavernous bodies). With this method, using a very thin needle in the base of penis, a medication is injected that enhances erection and blood supply of cavernous bodies. In MUSE method (drug-induced urethral system for restoring erection / transurethral application) blood-strengthening prostaglandin-E preparation is administered to urethra.
With vacuum therapy, plastic cylinder equipped with a pump is put on penis. As a result of lowering pressure below atmospheric, blood under the influence of vacuum intensively enters penis, due to which erection also occurs. Put on the root of penis rubber ring prevents outflow of blood. However, the ring should be removed after 30 minutes to avoid circulatory disorders.
For all forms of severe erectile dysfunction (for example, after radical surgery to remove prostate cancer or after suffering injuries), successful surgical treatment has existed for more than 40 years. In this case, through small cut during surgery, hydraulic implant is installed into penis. It consists of two cylinders, located along cavernous bodies. A pump is placed in the scrotum for activating and deactivating the process. A thin hose connects reservoir in hypogastric region. Pressing the pump under the skin of scrotum, the patient pushes sterile solution from reservoir into cylinders. In this case, penis becomes hard. Outwardly this in no way differs from natural erection. Sensitivity in penis is not disturbed, and the patient, as before, is able to experience orgasm and ejaculation. According to statistics, satisfaction of patient and partner each time exceeds 90%.
Erectile dysfunction: Course and Prognosis
Due to available options for treating ED, almost every patient can be helped. Important in this case is individual diagnosis and consultation, taking into account wishes and expectations of the patient and his intimate partner.