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Erectile dysfunction or impotence is a sexual dysfunction differentiated by the inability to develop or preserve an erection of the penis for pleasing sexual intercourse in spite of the ability of ejaculation. There are a variety of underlying causes, such as diabetes mellitus, many of which are medically reversible.
The causes may be physiological or may be psychological. Psychological impotence can often be helped by approximately anything that the patient believes in; there is a very brawny placebo effect.
Medical symptoms
Erectile dysfunction or impotence is characterized by the incapability to maintain erection. Normal erections during sleep and in the early morning recommend a psychogenic cause, while loss of these erections may mean underlying disease, often cardiovascular in origin. Other things leading to erectile dysfunction or impotence are diabetes mellitus (causing neuropathy) or hypogonadism (decreased testosterone levels due to disease distressing the testicles or the pituitary gland).
Medical diagnosis
There are no formal tests to diagnose erectile dysfunction or impotence. Some blood tests are usually done to leave out underlying disease, such as diabetes mellitus, hypogonadism and prolactinoma.
A useful and simple way to differentiate between physiological and psychological impotence and erectile dysfunction is to determine whether the patient ever has an erection. If never, the trouble is likely to be physiological; if sometimes (however infrequently), it is more likely to be psychological.
Clinical tests used to diagnose ED
Duplex ultrasound
Duplex ultrasound is used to assess blood flow, venous leak, signs of atherosclerosis, and blemish or calcification of erectile tissue. Injecting prostaglandin, a hormone-like stimulator formed in the body, induces erection. Ultrasound is then used to see vascular dilation and measure penile blood pressure. Measurements are compared to those taken when the penis is flaccid and not erected.
Penile nerves function
Tests such as the bulbo-cavernosus reaction test are used to decide if there is enough nerve sensation in the penis. The physician presses the glans (head) of the penis that right away causes the anus to contract if nerve function is normal. A physician measures the latency between squeeze and contraction by viewing the anal sphincter or by feeling it with a gloved finger put into past the anus. Specific nerve tests are used in patients with supposed nerve damage as a result of diabetes or nerve disease.
Nocturnal penile tumescence (NPT)
It is normal for a man to have 5 to 6 erections while asleep, particularly during rapid eye movement (REM). Their nonappearance may point out a problem with nerve function or blood supply in the penis. There are 2 methods for measuring changes in penile firmness and circumference during nocturnal erection:
- Snap gauge
- Strain gauge.
Penile bio-thesiometry
This test uses electromagnetic vibration to assess sensitivity and nerve function in the glans as well as shaft of the penis. A reduced perception of vibration may point out nerve damage in the pelvic area, which can lead to impotence or erectile dysfunction.
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2 pack Speman
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