What is erectile dysfunction

To determine the sexual deviations associated with erectile dysfunction, used modern medical term "erectile dysfunction". Previously, it was more common use of the definition of "impotence", the direct value of which - "failure to perform certain actions." Today, when a patient to see a doctor in order to solve the problem of increasing potency and interviews are used both terms. What is erectile dysfunction?

Erectile dysfunction - a partial or complete inability to achieve or maintain an erection necessary for satisfactory sexual intercourse successfully. Usually, the diagnosis of "impotence" is placed in the case, if a man is not able to maintain an erection more than 25% of sex acts that are trying to accomplish.

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Erectile dysfunction: predisposing factor

Erectile dysfunction is a multifactorial disease. Almost always highlighted several factors responsible for the development of the impotence of the patient. All conditions and diseases men, which lead to a decrease in blood flow (arterial insufficiency of the penis) to the cavernous bodies, or to an increase in blood flow (veno-occlusive dysfunction) of the corpora cavernosa, are factors for impotence. Most often, erectile dysfunction is associated with atherosclerosis, hypertension, diabetes, obesity, depression.

A study in Massachusetts found that introduction to exercise and regular training in middle age may help to reduce the threat of or the development of impotence, especially when compared to active men and their associates are not involved in sports. In this case, the risk is reduced by 70 percent. Dynamic observation over the next eight years also confirmed reduction in the incidence of erectile dysfunction.

A multicenter, randomized, open nature of the study to focus on the comparison. It was an analytical study of medical obese men with moderate symptoms of impotence, exercise and had time for two years to reduce their weight, the results of which were compared with the results obtained from the control group, in which information about healthy eating and active lifestyles remained common.

Increased activity by sports loads demonstrated not only improvement in BMI (under this abbreviation mean body mass index), but also indicators of strength, stamina, and sexual activity. Thus, scientists have determined that the decrease in total body weight and sufficient activity - important factors contributing to the normalization of erectile function.

However, for the official establishment of the degree of dependence on the whole lifestyle and physical activity, in particular with respect to the prevention and treatment of impotence controlled studies are needed in the long term.

The prevalence of erectile dysfunction

According to numerous studies, erectile dysfunction is a common disease. In all cases of impotence leads to lower quality of life for the patient. According to statistics, more than 30% of men aged 18 to 59 years of age have erectile dysfunction and need to increase potency.

The global situation is today more than 150 million men over 40 years suffer from erectile dysfunction and need to enhance potency. According to the forecasts of the National Institutes of Health of the United States by 2025 that number could increase by more than 2 times. Such negative trends are explained by an increase in risk factors for erectile dysfunction, among them - diabetes, a widespread cardiovascular disease.

Diagnosing Erectile Dysfunction

Usually, the doctor will know about the problems of erectile function of the patient during his initial conversations with him. There is also a special medical questionnaire to identify sexual dysfunctions and initial symptoms of impotence - the International Index of Erectile Function (IIEF-5). Answer 5 simple questions and to evaluate the presence of dysfunction on our website: go to the questionnaire IIEF-5.

Like any other illness, it is easier and more efficient to treat impotence in the initial stage. It is important not only to establish the diagnosis of "erectile dysfunction", and identify the cause of disturbances to develop policies aimed at increasing potency.

Diagnosis of impotence in the early stages is a collection of physical and psychological history. It is necessary to establish a mechanism to ensure the appearance of erection, disturbed. For making potency recovery rate must first pass analysis on blood hormones in some cases - to make test samples and the cardiovascular system. Timely professional diagnosis is the key to successful treatment of impotence.

Unfortunately, modern medicine pays little attention to the issue of interdependence of disorders of the nervous system and symptoms of erectile dysfunction. The main reason for that is still not developed effective methods for evaluating the so-called "neurogenic" component "of an erection. Neurogenic impotence dysfunction is a consequence of the defeat of structures of central and peripheral nervous system. For patients in our clinic developed neurogenic erectile dysfunction diagnosis method Kalinchenko-Rozhivanova. Among the common causes of this type of impotence - diabetes, alcohol consumption and smoking, as well as a number of long-term use of drugs. Diagnosis of neurogenic disorders is a fundamental step in the survey for the development of policies aimed at increasing potency.

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Erection attenuation mechanism

It was found that impotence is not an independent disease, and diagnostic symptom. Thus, sexual dysfunction may signal more serious health problems that require not only increase the potency.

Erectile dysfunction can be not only a consequence, but in many cases, and the harbinger of severe cardiovascular diseases. According to studies, 64% of the men hospitalized with a first myocardial infarction, disorders suffered erectile dysfunction for 3 years.

The main causes of impotence include:

  • psychological disorders;

  • neurological disorders;

  • problems with the endocrine system (low testosterone levels);

  • cardiovascular disorders;

  • anatomical defects of the penis;

Radical prostatectomy is a risk factor for impotence

Currently, prostate cancer is one of the most important problems in urology. The high prevalence of the disease conducts to an increase in various forms of treatment for prostate cancer. One of the most popular and effective methods of treatment for prostate cancer is radical prostatectomy.

All kinds of radical prostatectomy, including open, laparoscopic, and robotoassistiruemuyu, refer to the list of the most common procedures in order to eliminate producing clinically localized prostate cancer in terms of the expected duration of a patient's life by ten years or more. The results of this procedure can be specific consequences that have a direct impact on patient's quality of life (erectile dysfunction, urinary incontinence). According to studies, 25-75 per cent in the surgical removal of prostate tumors causes of erectile dysfunction, and from 5 - 50 percent incontinence.

As part prostatectomy impotence is a disease of multifactorial type. The disorder can be caused by pro-apoptotic and profibroznymi changes cavernous body of the penis as a consequence of damage to the cavernous nerve. In the first case we have to be the loss of smooth muscle tissue type, the second increase collagen levels. Both of these changes can also be triggered by insufficient supply of oxygen and blood to the cavernous bodies of the penis.

Given the patient's desire to preserve sexual function such as before surgery, trying to perform nerve-sparing radical prostatectomy. The success of this operation depends on the stage of the disease and engineering operations. However, a successful nerve-sparing prostatectomy is not 100% -Warranty saving erection.

Organic erectile dysfunction

Organic impotence is called man's inability to get an erection and maintain it, which is not connected with the psychological and mental factors. The most frequent causes of organic impotence are vascular pathologies.

The mechanism of erection problems

The cavernous arterial system, which supplies blood male sex organ, consists of the internal pudendal artery, arteries of the penis and the cavernous bodies. It possesses the unique ability to sharp increase in blood flow in response to stimulation of the pelvic nerve internal. normal blood flow at rest - 10 ml / min and 60 ml / min at the time of stimulation. This sudden flow of blood along with it at the same time neyropereraspredeleniem in the corpora cavernosa and cause an erection.

Lowering blood pressure in small vessels during sexual activity leads to insufficient blood supply to the corpus cavernosum, and hence causes problems with erection. This may explain the close relationship of impotence to aging. The defeat of the arterial bed can be of varying severity. For example, the complete impotence may indicate a serious vascular disease, and relatively full erection at rest, which disappears in the process of copulative frictions, may be a sign of a less serious diseases of the vascular system.

With the restriction of blood flow in the iliac arteries and the presence of occlusions in the internal pudendal artery, krovopritoka redistribution can occur in vessels of striated muscle. This redistribution krovopritoka manifested under load and active frictions, called the syndrome "steal".

Erectile dysfunction is a vascular origin most often occurs in patients suffering from hypertension, diabetes, diseases of the peripheral vascular, coronary heart disease, cerebrovascular insufficiency. A significant role in the occurrence of impotence plays tobacco smoking. A special group of patients with erectile dysfunction - a man with a history of perineal trauma, or irradiation.

Erectile dysfunction is a vascular genesis can be gradual, it is expressed increasingly rare sexual acts, premature ejaculation, erection and unstable failure to maintain an erection until ejaculation. Using patients antihypertensive drugs causes an even greater violation of potency.

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Neurogenic impotence and its treatment

Quite common type of organic erectile dysfunction is a neurogenic impotence. The key to a healthy potency is a healthy nervous system. Nervous system disorders (neurasthenia, neurosis, spinal cord injury, and others.) Can lead to impotence. Neurogenic character Factors violate the processes of development and maintenance of an erection.

Erectile dysfunction involves the mandatory neurological examination, especially if the patient suffered a neurological disorder, or in his history there is evidence of disease of the nervous system.

Neurological examination is the examination of the perineum and lower extremities. An assessment of the sensitivity of the skin of genitals and feet, as well as the determination of the threshold of sensitivity to vibration genitals conducted using biotenzometra. This procedure is inexpensive, it is absolutely painless and provides important diagnostic information.

Variations in sensitivity to the effects of vibration is an early sign of peripheral neuropathy. This test is based on a minimal stimulation of nerves, so it can be attributed to the most reliable evidence of sensory neuropathy.

Other methods of neurological diagnosis are: perineal muscle electromyography, measurement of refractory nerve sacrum, the registration of certain parts of the brain potentials during stimulation of the external genitalia. Comparing data neurological examination with the results of other studies, can most accurately diagnose neurogenic impotence character.

Depending on the causes of neurological lesions, erectile dysfunction can occur slowly or occur suddenly. It is worth mentioning that impotence occurs in the presence of neurological disorders related to alcoholism, diabetes, post-operative conditions, infections of the spinal cord, tumors and brain injury, degeneration of the intervertebral disks, cerebral insufficiency. Often, impotence has just two causes - neurological and vascular, such as patients with diabetes mellitus.