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Impotence - diagnosis,causes and treatment
Impotence - diagnosis, causes andtreatment.
Impotence or erectile dysfunction is the lack of ability to achieve or maintain an erection sufficient for sexual intercourse. Already by the age of forty nearly 40% of men in varying degrees, have erectile dysfunction. With age, this figure increases to seventy years is 70%.
Impotence causes
Impotence- a condition caused by a number of reasons. These causes can be divided into:
State, leading to disruption of blood flow to the cavernous bodies of the penis (the defeat of the arteries) or to increase the outflow of blood from them (a violation of valvular veins).
Chronic diseases: atherosclerosis, hypertension, diabetes mellitus. These diseases cause vascular lesions of the whole organism.
Depression and neurotic disorders.
The impact of environmental factors (electromagnetic radiation beam radiation).
Smoking.
Overweight.
Injuries to the genital organs and the spinal cord.
Drug effects (clonidine inhibit erectile function, beta-blockers, reserpine, cimetidine, ranitidine, metoclopramide, amitriptillin, Prozac, all anticancer drugs).
On the mechanism of development distinguish the following forms of erectile disorders:
organic
psychogenic
mixed.
Psychogenic impotence occurs with depression and neurotic disorders. Organic impotence is by origin:
vascular
neurogenic
hormonal origin.
Vascular erectile dysfunction occur in the arterial and venous insufficiency. . Lack of arterial blood supply to the penis appears in atherosclerosis iliac, internal pudendal artery and arteries of the penis itself. Sometimes a compression of these arteries trauma or benign and malignant tumors. Adverse effect on erectile function has hypertension.
Violation of neural regulation of erection occurs when the spinal cord injury, spinal cord blood flow disorders, multiple sclerosis and other degenerative diseases of the spinal cord. It may be a consequence of diseases and injuries of peripheral nerves that innervate the sex organs. Erectile dysfunction of hormonal origin occur in various endocrine diseases that lead to a breach of sexual hormones.
Psychogenic disorders are almost always accompanied by erectile dysfunction.
A normal erection is of three kinds:
adequate for sexual intercourse
spontaneous, which arises out of sexual activity, often in a dream
masturbation.
In psychogenic impotence decrease in erectile function occurs suddenly, after the stress of unpleasant events or experiences. This eliminates an adequate erection, and spontaneous erections and masturbation is often preserved. Adequate erection can be restored through sexual contact with another partner, or a change in conditions of sexual intercourse. Sometimes accompanied by a violation of psychogenic impotence sexual desire, loss of orgasm.
The vascular form of erectile dysfunction occurs gradually. Reduced all kinds of erection, when preservation of sexual desire. Sometimes vascular disorders cause a lessening of tension of the penis during intercourse and makes it impossible to complete.
Neurogenic forms of erectile dysfunction can manifest in different ways. Sometimes, even when the suspension of spinal cord erectile function can be restored after some time. If the damage of peripheral nerves erektiilnaya function is usually lost.
Impotence in endocrine disorders usually corresponds to the rate of decline of male sex hormones in the blood. With a gradual decrease in the number of sex hormones erectile function gradually decreases. As the degree of violation of erectile function distinguish compensated (minor), decompensated subcompensated and forms.
Diagnosis of erectile dysfunction begins with a detailed survey of the patient examination. We study the amount of hormones in the blood (testosterone, gonadotrophic hormones, estradiol). Pharmacological test is carried out: in the cavernous body is administered vasoactive medication and examine the degree of erection occurred. Conduct ultrasound vessels of the penis in different phases of erection and pharmacological stimulation of erection. Be sure to consult with the patient's neuropsychiatrist.
Treatment of erectile dysfunction.
Treatment of erectile dysfunction is a conservative and operative.
Initially, conservative treatment is carried out. First of all, are treated with the disease, which is the basis of erectile dysfunction. Carried out the normalization of blood pressure, blood glucose, etc. For a long time appointed biogenic stimulators and adaptogens: tincture of ginseng, Eleutherococcus, devil, Manchurian Aralia, Pantocrinum. Typically, these drugs are advised to take about six months. To improve the blood supply to the penis are appointed by vasodilators, antiplatelet agents, antioxidants, reinforcing agents vascular wall. In the treatment of neurogenic erectile dysfunction using B vitamins, Neostigmine, physiotherapy. In endocrine disorders is sometimes necessary to use hormone replacement therapy. Obligatory in psychotherapy.
In severe forms of erectile dysfunction surgical treatment. Surgical treatment can be directed at increasing the inflow of arterial blood to the penis, or to correct violations of the venous circulation. The most severe forms of impotence may require replacement. This operation is called tetralogy of Fallot arthroplasty. In the cavernous body is inserted silicone rods or cylinders. The modern design of prostheses allow the patient to simulate an erection as necessary. The results of this treatment is very good. In general, the prognosis of all forms of impotence favorable, they all respond well to treatment.
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