What is Erectile Dysfunction (Impotence) ?
Erectile dysfunction, impotence or erectile dysfunction is the condition where the penis cannot reach a level of erectionthat can lead to a successful sexual intercourse, or that it cannot sustain this level of erection even when it reaches. This situation is mostly seen in men over 40 years of age.
What is the Incidence of Erectile Problem?
Erectile problem is a common problem in the community. Most men experience problems about erection during a certain period of their lives. There may be problems with erection, especially when under stress or when a serious illness is experienced. However, this should not continue for a long time. In males between the ages of 40 and 70, the rate of erectile dysfunction is about 30%. With increasing age, the incidence and severity of erectile dysfunction increases.
What are the causes of Impotence?
Impotence is caused by various reasons, psychological, physiological or physical. The main causes of impotence are;
Psychological Diseases: For the erection, the person’s mood should be healthy. Problems in the workplace or family, economic difficulties or problems with partners and depression affect the mood of the person positively and impair the quality of the erection.
Systemic Diseases: Systemic diseases that cause damage to many organs and systems in the body such as diabetes, arteriosclerosis, high cholesterol and hypertension can cause erectile dysfunction. Approximately half of men with diabetes and heart disease have impotence problems or acquire it in later years.
Nervous System Diseases:
The diabetes affecting the penis nerves, alcohol dependence or nervous system diseases can cause impotence. In addition, injury to the nerves during spinal injuries or surgeries may lead to impotence.
Chronic diseases: Chronic liver disease and chronic renal failure disease in patients with erectile dysfunction is common.
Hormonal Disorders: The lack of testosterone hormone, especially the male hormone and the lack of thyroid hormone or increase of thyroid hormone can lead to impotence.
Urinary Tract Diseases: Urinary tract infection, prostate inflammation, prostate enlargement and prostate cancer can lead to impotence both by causing physiological disorders and by disrupting the quality of life of the person.
Smoking: In males, the incidence of impotence varies between 50 and 70%. This rate varies depending on the amount and duration of cigarettes smoked.
Drug Use: Some medications and hormones and a number of drugs that affect neural stimulation can cause impotence.
Obesity: Obesity, diabetes, increased insulin resistance and metabolic syndrome are important risk factors for the development of erectile dysfunction.
Penile Anatomical Disorders: Small penis, penile curvature, in case of hypospadias disease with wrong placement of urinary meatus can cause impotence.
How to Diagnose the Erectile Problem?
Whether the person has aerection problem can only be understood by the examination of the doctor. Some of the information obtained from the patient and the examination is sufficient to make a diagnosis. If necessary, some tests may be required to help diagnose.
Color doppler ultrasonography is a test that measures blood flow in the penis vessels with the help of sound waves. In Papaverine test, some drugs that provide erection are injected into the penis and it is observed whether there is enough erection or not.
In another test called as nocturnal penile tumensis, it is learned about the degree of erectionof the penis during the sleep and its degree. Normally, every man has 3 to 5 times erection during the night sleep. If there is an underlying disease, the frequency and degree of these erection decreases. In the case of impotence due to psychological reasons, these erections are seen as normal.
How is the Erectile Problem Treated?
Treatment of erectile dysfunction depends on the underlying cause. However, there are 4 main treatment methods used in the treatment of erectile dysfunction. These;
- Medications used orally
- Vacuum device
- Injection of certain drugs into the penis
- Penis prosthesis (joystick)
None of these treatment methods eliminates the cause of erectile dysfunction. It only allows the penis to reach the erection level that will ensure sexual intercourse.
The first-line treatment of the erection problem is drugs that are taken orally. These drugs are called phosphodiesterase type 5 enzyme inhibitors, sildenafil citrate (viagra), vardenatil (levitra) and tadalafil (cialis).
The most common side effects of these drugs are headache, fullness in the nose, hot flashes, headache and muscle pain.
Vacuum devices consist of a plastic cylinder, a vacuum pump and an elastic rubber for compressing the penis. The penis is erected by the action of the vacuum device. Then the compression band is placed on the root of the erected penis. The compression band can stay here for half an hour. During this time the relationship is established and then this tape is removed.
Inject some vasodilator into the penis through the help of a thin needle. These drugs to relax the muscles and veins in the penis tissue to fill the penis into the penis and an erection occurs.
Injection of the drug into the penis is applied to patients who have not tried the drugs previously taken orally. This procedure can be easily performed at home by the patient or his partner.
Penis prosthesis surgery, two penis prosthesis resembling cylinders are placed inside the penis. The implanted prosthesis does not affect urination, ejaculation and orgasm. There are two types of prostheses that can be twisted or inflatable