Impotence (Erectile Dysfunction)

DEFINITIONS

Impotence (Erectile Dysfunction) is the inability to initiate and maintain an erection.

CAUSE 

Impotence is usually the result of:

# Abnormal blood vessels

# Abnormal neural

# Drugs

# Abnormalities of the penis

# Problems affecting mental sexual arousal.

Physical causes of more common in older men, while psychological problems are more common in younger men.Increasing age of a man, then the impotence becoming more frequent, although impotence is not part of the aging process but it is a result of diseases that are often found in elderly.Approximately 50% of men aged 65 years and 75%, 80-year-old man experiencing impotence.

In order to erect, the penis requires adequate blood flow. Because it is a disease of blood vessels (eg atherosclerosis) can cause impotence.Impotence can also occur as a result of a blood clot due to surgery or blood vessels that cause the disruption of arterial blood flow to the penis.

Nerve damage leading to and leaving the penis can also cause impotence.This nerve damage can occur due to:

# Injuries

# Diabetes mellitus

# Multiple sclerosis

# Stroke

# Drugs

# Alcohol

# Diseases of the spine bottom

# Rectal or prostate surgery.

Approximately 25% of cases of impotence caused by medication (especially in older men who consume lots of drugs).These drugs can cause impotence are:- Anti-hypertension- Anti-psychosis- Anti-depressants- Sedative- Cimetidine- Lithium.

Impotence sometimes caused by low levels of testosterone.But the decline in male hormone levels (which tend to occur due to aging process), usually more often cause a decrease in sexual desire (libido). Some psychological factors that may cause impotence:

# Depression

# Anxiety

# Feelings of guilt

# Feelings of fear of intimacy

# Indecision about gender.

SYMPTOMS 

Patients are not able to initiate and maintain an erection.

DIAGNOSIS 

Diagnosis based on symptoms.Physical examination conducted to seek a change in male sexual traits, such as breasts, testes and penis, as well as changes in hair, skin and voice. To find out the abnormalities in the arteries in the pelvis and groin (which supplies blood to the penis), measurement of blood pressure in the leg. Other tests that may need to be done:

# Full blood examination

# Check your blood sugar for diabetes

# The measurement of TSH

# Ultrasound of the penis.

TREATMENT 

Impotence is usually treatable without surgery.Type of treatment depends on the cause. Special exercises done by patients with impotence due to psychological problems, the so-called convergence technique sensation three stages.This technique encourages intimacy and emotional warmth, which is focused to build a relationship:

1. Phase I: flirt, fun couples to concentrate on each other without touching the pubic region.
2. Phase II: the couple began to touch the genital area or other erotic areas, but not the act of intercourse.
3. Phase III: the act of intercourse.

Each achieve comfort at every stage of intimacy before continuing to the next stage.If this technique does not work, patients may need to undergo psychotherapy or behavioral therapy sexual.If patients are depressed, antidepressants can be given.

Sildenafil is a drug that could meningkatkanaliran blood to the penis.This drug is taken 30-60 minutes before sexual intercourse, is only effective if accompanied by sexual arousal.Should not be taken along with nitrates may lead to serious side effects.

If impotence or loss of sexual desire due to low testosterone levels, patients should undergo hormone replacement therapy.Testosterone was injected every week or granted in the form of plaster.The side-effect is the enlargement of the prostate and the excess red blood cells that can lead to stroke.

Binding instrument or a vacuum is often used to achieve and maintain an erection, but this tool should not be used by people with bleeding disorders or patients who take anticoagulant drugs.Binding tool (a rope or a ring made of metal, rubber or leather) is installed at the base of the penis to slow the flow of blood from the penis.Vacuum (in the form of hollow box and pump) mounted on the penis. Vacuum pressure helps blood flowing into the arteries of the penis. When the penis is erect, a device installed to prevent the fastener from the venous blood flowing. Combination of these two devices can sustain an erection for 30 minutes.Sometimes fastener tools cause problems when ejaculation, especially if tied too tight. For the sake of security, preferably after 30 minutes of the tool is released.If it is too often used, the vacuum can cause bruising.

Impotence can also be treated with injections of specific drugs taken by patients themselves.This drug is injected directly into erectile tissue of the penis (corpus cavernous. Erection occurs within 5-10 minutes after drug injection and can last for 60 minutes.The side effects are bruising and pain. In addition, the injection can also cause Priapism (persistent and painful erection).

If impotence does not respond to various treatments mentioned above, can be used in transplant a penis or prosthesis (artificial penis).One of the tools in the form of the transplanted stem stout inserted into the penis to cause an erection that stay. Another tool in the form of a balloon inserted into the penis and inflated before the patient had sexual intercourse.

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