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Every fifth man may experience these phenomena, and in the age group between 40 and 70 years of age, more than half of men experience problems associated with erection. Not everyone is ready to find out for themselves the reasons why a diagnosis is made: "Impotence" (medical name: "erectile dysfunction"), although the possibilities of diagnosis and treatment have improved greatly in recent years.

Every man experiences in his life one or more episodes of lack of erection or, at least, fear of such a situation, but the symptoms of the disease can only be discussed if for a long time (more than 6 months) there was a lack of occurrence and maintenance of a sufficient erection for a satisfying intercourse.

Contrary to the statements of the media, one can be sure: with age, the potency is weakened, but does not disappear.
Erection (hardening of the male penis) is a peculiar interaction of many factors, for example, sexual fantasies, erotic stimuli and touch, which lead to stimulation of nerve cells and, under the influence of impulses, to filling the cavities of the cavernous bodies with blood, increased blood circulation and slowing down the outflow of blood through veins. In the event of a violation of the interaction of arterial blood inflow, expansion of the cavernous bodies and outflow of blood through the veins, as a result, an undesirable violation of the hardening of the penis is observed. When the various functions of the organs must correspond to each other in the most subtle temporal sequence, defects and disorders are inevitable.

Causes

A large number of possible causes can lead to erectile dysfunction. They can be organic factors such as vascular changes, nerve damage, genital diseases or hormonal disorders, but blood pressure lowering and psychotropic drugs, alcohol and nicotine can also have a negative effect on erection.

Symptoms

For a long time (more than 6 months), there is a lack of occurrence and maintenance of sufficient erection for a satisfactory sexual intercourse.

Diagnostics

To systematize the factors, the patient receives a questionnaire. This cooperation with the patient allows the specialist doctor to recognize and classify negative factors. Possible causes of erectile dysfunction are then discussed together, falling into one of three categories.

Only about 5% patients show deficiencies at the hormonal level (in the formation and action of hormones). 25% have psychogenic (psychological) or neurotic causes of disorders, and all the rest have disorders or lesions of the vascular system.

Our questionnaire makes it possible to understand where the problems are rooted. In a conversation with a doctor, specific manifestations of the disorder are discussed: insufficient hardening of the penis (rigidity) or the impossibility of increasing the volume (tumescence)? Or insufficient duration of rigidity? Discussion of other diseases and previous operations is also of great importance in the survey.

To identify the cause of potency disorders, a general physical examination of the patient is performed. Special diagnostic measures should show the degree of blood flow to the penis and its outflow, as well as the ability to expand the cavernous bodies. A thin needle (microneedle of the “mosquito bite” type) is used to inject a special medication into the root of the penis. After that, it is possible to determine the blood flow, as well as its painless measurement by ultrasound echography (color Doppler ultrasound). In rare cases, an X-ray examination is indicated.

Treatment

There is a wide range of treatment options, from medical to surgical, which are used depending on the causes of the disease. Most men get by on pills as temporary or long-term support. Others learn how to inject themselves, and still others successfully use a vacuum pump. Depending on the cause of erectile dysfunction and based on the individual assessment of the patient, a high degree of satisfaction can be achieved, also with partners.

Предпосылкой для такой терапии является преодоление пациентом «порога стыдливости, неловкости». Мужчина, столкнувшийся с этой проблемой, должен быть готов говорить об этом и в деталях описать картину своих жалоб. Сдержанность и такт являются само сабой разумеющимися правилами работы врача. окончательный диагноз. И тогда, вопреки бытующему мнению: «Теперь уж всё равно всё поздно!», можно, благодаря надлежащей диагностике, провести своевременное, щадящее и – часто – сохраняющее орган лечение, которое с большой вероятностью гарантирует выздоровление.

Professor, Doctor of Medical Sciences
Head of Urology Clinic
Professor, Doctor of Medical Sciences
Head of Urology Clinic
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