Erectile dysfunction (impotence)

Erectile dysfunction (impotence) - a constant lack of ability to achieve and / or maintain an erection sufficient for a full sexual intercourse. Despite the fact that erectile dysfunction (impotence) does not apply to serious health problems, it can significantly affect a man's mental status, reduce the quality of his life, violate partnerships and the strength of the family.

[1]

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 provided by neurovascular mechanisms under the control of mental and hormonal influences. This leads to dilatation 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. Obviously, any factors that lead to a reduction in arterial influx to cavernous bodies (arterial insufficiency of the penis) or an increase in venous outflow (veno-occlusive disorders) can cause erectile dysfunction (impotence).

Erectile dysfunction (impotence) develops due to the same factors as diseases of the cardiovascular system: age, depression,  inactivity, obesity, tobacco smoking, drug use, hyperlipidemia and metabolic syndrome.

[2], [3], [4], [5], [6], [7],

Forms

Erectile dysfunction (impotence) is classified by severity: mild, moderate, severe; and the reasons for its occurrence: organic, psychogenic and combined, i.e. Combining mental and organic factors. It should be borne in mind that psychogenic effects are present in all types of erectile dysfunction (impotence).

[8], [9], [10], [11]

Diagnostics of the erectile dysfunction (impotence)

Erectile dysfunction (impotence) is difficult to diagnose, this diagnosis has several purposes:

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

Diagnosis is recommended to begin with a detailed conversation with the patient, collecting information about the state of his health in general and mental status. Analyze the data of the general and sexological anamnesis, as well as the state of the copulative function earlier and at the present time. It is necessary to obtain information about the nature of the relationship with the sexual partner, prior consultation and treatment.

[12], [13], [14], [15]

Treatment of the erectile dysfunction (impotence)

Erectile dysfunction (impotence) is treated for a specific purpose - this is the achievement of the quality of erections, which is necessary for a full sexual intercourse. The patient should be informed about the possible methods, their effectiveness and negative properties.

Erectile dysfunction (impotence) is treated with the use of an etiological and pathogenetic approach. First of all, it concerns diabetes, arterial hypertension,  metabolic syndrome. Persistent cure for erectile dysfunction (impotence) can be expected in cases of psychogenic erectile dysfunction (impotence) (rational psychotherapy), posttraumatic arteriogenic erectile dysfunction (impotence) in young men, with hormonal disorders (hypogonadism, hyperprolactinaemia).

Prevention

Erectile dysfunction (impotence) can be prevented with the help of the following methods: normalization of a way of life, sufficient physical activity, exclusion of tobacco smoking, restriction of alcohol consumption, control and correction of body weight, glucose  and lipid content  in the blood, and regular sexual activity.

[16], [17], [18], [19]

Forecast

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

[20], [21], [22]