A common cause of impotence is inflammation of the reproductive system that arise from infections transmitted through sexual contact (chlamydia, mycoplasma, trichomonas, gonococci, etc..). Origin impotence consists, on the one hand, that is affected reproductive system (prostate, seminal vesicles and seminal tubercle), and on the other hand psychogenic factor appears.
Erectile dysfunction caused by these diseases, suffers not only from the destruction of the receptor apparatus, moreover, it disrupted the functioning of the nervous and other elements of the regulation, for example, spinal sexual centers. Patients often suffer from various neurological disorders.
Chronic inflammatory diseases of the reproductive system, their frequent and persistent recurrence, fear of complications, which may cause sexual dysfunction, excessive attention to his patients as cause permanent and long-term stress and traumatic for the psyche. Often, such a patient attempts to perform a sexual act lead to failure for the simple reason that at the right moment, he had problems with erection. All this causes a deterioration in the clinical course of impotence.
Impotence caused by inflammatory diseases of the genital organs, in their clinical picture is characterized by progressive weakening of erection, although sexual desire remains, however, there are also cases of decreased libido. For patients characterized by fatigue, sleep disturbances, impaired performance, and depression. All of these factors alone can cause functional disorders and sexual administered spinal centers in the pathological state which, in turn, contributes to the development and maintenance of impotence.
Diagnosis of impotence - a rather difficult process that must take into account the physiological and psychological mechanisms of this disease.Erectile dysfunction - is not only a psychological problem, it is important to give appropriate attention to pathophysiological causes disease to impotence treatment proved as efficient as possible.
Clinical examination often reveals a number of symptoms indicating the pathophysiological origin of impotence on the basis of the collected history data. Carefully collected and studied history allows you to properly evaluate the pathophysiological causes of impotence and appropriate treatment of erectile dysfunction. The history of the sexual life of the patient should include all the problems associated with impaired sexual function of the patient. First of all, the urologist doctor must find out:
that the patient believes impotence, because it is often confused with decreased libido or impaired ejaculation;
set the time of occurrence of this form of sexual disorder and its start (rapid or gradual development);
what is the frequency of sexual intercourse at this time and until the disease;
the patient's ability to ejaculate - or is insufficient erection quality or premature ejaculation, or simultaneously both;
are not by any chance a weak erection and / or premature ejaculation;
be sure to find out the presence of the patient's sexual desire in convergence, as well as the impact on the quality of sexual stimulation erection.
If the history of sexuality in sufficient detail, taking into account all of the above information, it is possible to diagnose the type of impotence. If psychological reasons it is possible that erection problems come sharply after a few days or weeks, while on erection quality strongly influences the situation. Most often this phenomenon is characteristic of young people, single men, and in the absence of a regular sexual life and life situations are usually attempt sexual intercourse at the wrong conditions or in the commission of the first sexual contact. Patients complain of this kind, as a rule, ejaculation disorders and libido. These problems often cause partner dissatisfaction, man loses confidence, it appears the fear of failure and anxiety.
Organic impotence usually has a vascular origin. In these patients, there is a gradual fading erections - they come into sexual contact from several times a week to rare episodes during the month. Sexual attraction have preserved, ejaculation is normal or slightly premature and inadequate erection quality, independent of sexual stimulation.
Nevertheless, to confirm the hypothesis pathophysiological necessary to objectively evaluate the erectile function of the patient. For example, patients whose impotence has a psychological origin, may argue that morning erections they do not have, and the erection has disappeared not suddenly, but gradually. On the contrary, with impotence of organic origin, morning erections can be preserved, and erectile dysfunction can occur suddenly, especially if it is connected with carrying out radical surgery on the pelvic organs, exposure to harmful environmental conditions and injuries. At the same time, patients with organic impotence also suffer from other pathologies, completely masking the origin of organic erectile dysfunction, and their examination did not reveal any objective symptoms.
Collecting common history, urologist doctor should also find out:
any infectious or other diseases of the patient suffered;
if he had severe psychological and emotional experiences and troubles at work and in everyday life;
whether he smokes and how much;
frequency and amount of alcohol consumed;
the presence of cardiovascular disease and patients with their family;
whether the patient noticed weakness in the limbs;
if he had problems with urination or defecation.
It is necessary to establish exactly what medicines the patient uses or used, in particular, this applies to antihypertensive drugs. Diagnostic steps can not be reduced only to the history and physical examination. There should also be made of research, to find out some of the physiological mechanisms of erection, including the presence of nocturnal erections, and determining the state of the cardiovascular and endocrine systems of the patient, his neurological and mental condition, his family relationships and living conditions.
Prostatitis - the disease, I am familiar with many men. At its core, prostatitis is an inflammation of the prostate gland. The prostate, an organ of the reproductive system, not directly related to the potency, so it seems to be the disease should not cause erectile dysfunction. However, the prostate is located close to the male genitalia, they have a common system of blood supply and innervation.
Prostatitis occurs swelling body and forming stagnation, resulting in the blood supply to the prostate and in the space around it can be broken. The result is a violation of the blood supply to the pelvic organs and the penis, which leads to problems with erection. That is, the pain in the prostate gland are not the consequence of one of prostatitis, it often causes impotence and infertility men. But, unfortunately, not all men know that problems with erection and male infertility may be due to it prostatitis.
Sometimes erectile dysfunction may occur as a result of complications of prostate and its cause is psychological and physiological factors. Constant exhausting pain and a number of other symptoms increase anxiety and cause depression, and these psychiatric disorders have an effect on libido. Diseases of the epididymis and prostate can cause discomfort and pain during erection and sexual intercourse, and over time this leads to the fact that developing erectile dysfunction.
Many patients suffering from male infertility and / or erectile dysfunction, did not take into account the factor of infection. They do not realize that their sexual problems are caused by a chronic infection it, which led to chronic prostatitis. Symptoms of pain and prostatitis may be a different character, so a relatively weak non-permanent pain or symptoms of serious problems patients may be underestimated.
Independently set the disease prostatitis is quite simple - it is the presence of a soft, dull pain or discomfort in the perineum, are not strongly pronounced pain during erection and ejaculation. These symptoms of prostatitis can not pay attention. Prostatitis is often very painful, however, there are cases where the pain is almost there. Infection itself may not cause severe pain and other symptoms characteristic of, but significant effect on the formation of sperm.
For the treatment of prostatitis, which caused male infertility and / or impotence, apply a comprehensive approach, which consists in the elimination of stagnation and infections in the urinary system, the treatment deferentita, vesiculitis, epididymitis, urethritis. If you have a swelling or an enlarged prostate, in infections and inflammation of the epididymis ejaculatory tract antibiotic treatment made and natural medicines.
Impotence, which is a cause of prostatitis, izlechivaema. Treatment of erectile dysfunction in this case is to eliminate the infection and elimination of blockages in the prostate. Upon completion of the treatment of prostatitis prostate pain disappear, and with them, gradually fading and psychological problems.
If infectious lesions of the urogenital system, causing prostatitis and erectile dysfunction, your doctor first patient studied semen analysis and assessed the degree of obstruction of the reproductive system organs - it needs to deliver the semen analysis at Kruger. If necessary, the urologist andrologist appoints ultrasound of the penis and scrotum and abdominal ultrasound. This is the most common diagnosis of prostatitis. His treatment is performed by injections into the prostate of homeopathic medicines and antibiotics, and drug therapy.
After carrying out these procedures are eliminated infection and occlusion, resulting in a disappearing patient discomfort and pain during erection and ejaculation. Gradually erection problems come to naught, recovering morning erection and libido, and ejaculation becomes stronger.
The Andrology there are two major problems - this impotence (erectile dysfunction) and infertility men. Today it is common knowledge that men with age reduced level of sex hormones, particularly testosterone, and occur simultaneously with the erection problems. And this decline begins between the ages of 30-40 years. In general, the level of this hormone is different in different people, even of the same age, since it is influenced by many factors - lifestyle related diseases, bad habits, particularly genetics and the human body structure.
Associated diseases such diabetes mellitus, hypertension and ischemic heart disease lead to the reduction of testosterone by 10-15% as compared with healthy persons in the same age group.
Age-related decline in the level of biologically active testosterone is even greater than the decrease in total testosterone levels. Many men after 50-60 years have symptoms typical of hypogonadism. These symptoms include:
Disorders of the genitourinary system, consisting in the reduction of libido, erectile dysfunction, orgasmic disorders, reduced sperm fertility, pollakiuria (not associated with benign prostate enlargement);
Symptoms vegetovascular disorders, consisting in a sudden reddening of the face, neck, upper body, in the so-called "hot flashes" in the race in blood pressure in of chest pains, dizziness, lack of air;
Disorders of psychological and emotional spheres, manifested in increased irritability, fatigue, weakening of memory and attention, insomnia, depression, decreased well-being and health;
Bodily disorders, which are expressed in a decrease in muscle mass and strength, decreased bone density, gynecomastia, the appearance or the build-up of visceral obesity, reducing the number of androgenozavisimyh hair in thinning and atrophy of the skin;
Changes in laboratory assays, indicating overall reduction of the biologically active testosterone levels, increasing levels of the hormones estradiol and globulin appearance of varying degrees of anemia, improving lipoprotein and very low density.
We should not think that the appearance of the symptoms described above are uniquely related to the level of sex hormones. However, treatment of erectile dysfunction via androgen therapy confirmed their importance and gave the elimination or reduction of the severity of these symptoms.
Studies have been conducted that have proven connection with hypogonadism dyslipoproteinaemia and the fact that the treatment of impotence drug therapy for hypogonadism gives the normalization of fat metabolism in the body. If unable to treat erectile dysfunction medications, urologist, andrologist offer falloprotezirovanie. Modern prosthetic penis is not visible, a high degree of engraftment and a minimum of side effects. Falloprotezirovanie is the gold standard for the treatment of impotence in the world.
The causes of male infertility are many and they are due to genetic abnormalities and environmental factors and lifestyle. Any medical condition, whether it is acute or chronic, can lead to disorders of spermatogenesis and male infertility. Violations of pituitary function, hypothalamus, thyroid or adrenal gland is diagnosed in approximately 4% of the men held a study on the causes of infertility. In specialized hospitals hypogonadism due to disorders of the endocrine system may be 9%.
Just about every 7th infertile men observed defects in the sex chromosomes, defeat ejaculatory tract, cryptorchidism, and other types of testicular failure. In 6% of cases of male infertility was due to congenital or acquired lesions of the epididymis, and in 5% of causes were improper technique intercourse, erectile dysfunction, ejaculation or anatomical abnormalities, a large part of them is given hypospadias. In the 6 - 10% of the capacity to fertilize it has been broken due to autoimmune processes that lead to agglutination and poor sperm motility. Up to 40% of infertile men have a varicocele disease, and 15% of male infertility held subclinical. In about 35% of infertile men the cause of infertility is not detected, it is called idiopathic (unclear), male infertility, challenging modern urology.
The above statistics - this is just tip of the iceberg called male infertility, as it is assembled on the married couples who applied for medical assistance. These data do not include unmarried men, and more particularly those who have no idea about their infertility, or simply do not wish to be examined and treated.
If diagnosed hypogonadotropic hypogonadism, it is treated with gonadotropins. Inflammatory processes of sexual system of men cure using appropriate antibiotics and symptomatic anti-inflammatory drugs and procedures. Hopes for a successful exposure of glucocorticoids for antibodies to the sperm did not materialize. Also, there are no methods for the treatment of infertility in men is the primary cause hypergonadotrophic hypogonadism, ciliary immobility syndrome and chromosomal abnormalities.
It is clear that the treatment of idiopathic infertility is empirical, and for the most part is an unsatisfactory result. Several studies have shown that the use of testosterone in the male andropause lipase activity causes a decrease in visceral fat, glucose levels, triglycerides and cholesterol in the plasma and reduces the diastolic blood pressure.
If the treatment of metabolic and hormonal abnormalities apply testosterone and other hormone preparations, it increases the possibility of occurrence of benign prostatic hyperplasia. 8-month use of testosterone showed that the prostate has increased by 12%, however, prostate specific antigen did not change the concentration.
It is known that taking androgens inhibits endocrine testicular function and spermatogenesis due to negative feedback. In particular, this effect is observed with injections of drugs with a long half-life. It is also noted that the incidence of androgen therapy apnea may increase in patients. But it is possible that this side effect is characteristic mainly for those with obesity or chronic pulmonary disease.
When androgen therapy may be complications in the form of fluid retention in the body, a physiological increase appetite, tendency to thrombosis. Thus, the side effects and the possibility of adverse consequences of receiving testosterone and its derivatives lead to the need to choose an alternative drug for the treatment.