Erectile dysfunction (impotence)

Erectile dysfunction (impotence) is a permanent inability to achieve and/or maintain an erection sufficient for full sexual intercourse. Although erectile dysfunction (impotence) is not a serious health disorder, it can significantly affect a man's mental status, reduce his quality of life, disrupt partnerships and family strength.

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Epidemiology

Erectile dysfunction (impotence) of moderate to severe severity occurs in 10-20% of men, and its frequency increases with age.

The development of erection is ensured by neurovascular mechanisms under the control of mental and hormonal influences. This involves dilation of the arteries of the penis, relaxation of the trabecular smooth muscles and expansion of the cells of the cavernous bodies in combination with organ venous occlusion. It is obvious that any factors leading to a decrease in arterial inflow to the cavernous bodies (arterial insufficiency of the penis) or to an increase in venous outflow (veno-occlusive disorders) can cause erectile dysfunction (impotence).

Erectile dysfunction (impotence) develops as a result of the same factors as cardiovascular diseases: age, depression, physical inactivity, obesity, smoking, drug use, hyperlipidemia and metabolic syndrome.

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Forms

Erectile dysfunction (impotence) is classified by severity: mild, moderate, severe; and by the causes of its occurrence: organic, psychogenic and combined, i.e. combining mental and organic factors. It should be taken into account that psychogenic influences are present in all types of erectile dysfunction (impotence).

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Diagnostics erectile dysfunction (impotence)

Erectile dysfunction (impotence) is difficult to diagnose; this diagnosis has several goals:

• confirm the presence of erectile dysfunction (impotence);
• determine the severity of erectile dysfunction (impotence);
• find out the cause of erectile dysfunction (impotence), i.e. the disease that caused its development;
• determine whether the patient suffers only from erectile dysfunction (impotence) or it is combined with other types of sexual dysfunction.

It is recommended to begin diagnostics with a detailed conversation with the patient, collecting information about his overall health and mental status. General and sexological anamnesis data are analyzed, as well as the state of the copulative function previously and currently. It is necessary to obtain information about the nature of the relationship with the sexual partner, previous consultations and treatment measures.

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Treatment erectile dysfunction (impotence)

Erectile dysfunction (impotence) is treated with a specific goal - this is to achieve the quality of erections that is necessary for a full sexual intercourse. The patient must be informed about possible methods, their effectiveness and negative properties.

Erectile dysfunction (impotence) is treated using the etiologic and pathogenetic approach. First of all, this concerns diabetes mellitus, arterial hypertension, metabolic syndrome. A stable cure for erectile dysfunction (impotence) can be expected in cases of psychogenic erectile dysfunction (impotence) (rational psychotherapy), post-traumatic arteriogenic erectile dysfunction (impotence) in young men, and hormonal disorders (hypogonadism, hyperprolactinemia).

Prevention

Erectile dysfunction (impotence) can be prevented by the following methods: normalizing lifestyle, sufficient physical activity, eliminating smoking, limiting alcohol consumption, monitoring and correcting body weight, blood glucose and lipid levels, and regular sexual activity.

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Forecast

Individually selected and step-by-step application of modern methods of treating erectile dysfunction (impotence) allows in the vast majority of cases to achieve sexual rehabilitation of patients.

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