This condition affects men of all ages and is often associate with other common diseases: atherosclerosis,
More than 300 million men are affect; most cases are the result of vascular damage, including inadequate arterial blood supply to the penis, so many researchers have suggested that stent implant interventions in the pelvic arteries, including the routes that provide penile vascularization, may improve ED and, consequently, sexual function.
Causes of erectile dysfunction
DE may have different etiologies, which are directly related to age. For example, in the case of adolescents and young people, the most common causes are psychological (insecurity, lack of experience, fear of unwanted pregnancy). Doctor Ali provides the best health and wellness center in the USA. In the case of middle-aged men, stress is often involved.
Diseases such as diabetes and atherosclerosis play an essential role – organic causes of ED. These are all the more common as you get older. Due to the damage to the vessels that ensure the vascularization of the penis, ED is the most common.
1. DE psychogenic
DE may be due to mental impairment and relational status. ED can occur in stress, lack of sexual desire, borderline cases, or depression. This category may include:
- fear of sexual intercourse or an unwanted pregnancy
- depression, stress
- relationship problems
- previous negative sexual experiences
When the cause of ED is unsafe, mental illness should not be blamed, and other causes should be investigated. The diagnosis is based on conversation and specific psychological tests, and the treatment may be of the type of psychotherapy (but not before excluding other organic causes).
2. DE organic
Neurogenic: nerve transmission to the penis is affected, which decreases the blood flow needed to get and maintain an erection. Conditions associated with ED
Are multiple sclerosis, diabetic neuropathy (a complication of diabetes), various traumas (e.g., spinal cord). It is a condition that is difficult to treat, as the nervous system has a limited ability to regenerate, and this condition is usually not completely reversible.
Hormonal abnormalities lead to low production of sex hormones, so their level in the blood will be low, which leads to decreased libido and ability to maintain an erection and can also affect the quality of the erection. It is a common cause of ED, so specific blood and urine tests are required for diagnostic purposes.
Vascular: Vascular damage is responsible for most of the causes of ED, and atherosclerosis is the main problem. However, vascular damage is also possible in trauma or congenital disabilities.
Atherosclerosis is characterized by the deposition of cholesterol plaques in all arterial vessels in the body, including the penile vessels, leading to a narrowing of the diameter of the affected vessel. In addition, over time, these cholesterol plaques tend to calcify, further affecting the vessel’s ability to dilate and allow, if necessary, a greater flow of blood.
Vascular mechanism of ED
The vascular mechanism of ED is similar to that of coronary artery disease, myocardial infarction, or ischemic stroke. Affected vessels cannot provide the necessary blood in the organs, leading to ischemia and loss of function. Given that the penile arteries have a smaller diameter than the coronary arteries, it is easy to understand why ED can precede damage to the vessels in the heart or other organs. Therefore, a complete diagnostic protocol is essential for men with ED.
It is also known that diabetes and high blood glucose are associated with ED.
Drug-induced: psychiatric, hormonal, or chemotherapy treatments. However, most commonly, antihypertensive drugs can have this effect. That is why it is essential to choose them, considering comorbidities.
Other causes: ED can be caused by conditions such as:
- damage to the genitals (surgery, trauma)
- prostate hyperplasia (increase in prostate volume)
- smoking
- alcohol
- drugs
Symptoms of erectile dysfunction
Despite the proper arousal and context, a vital sign is a significant increase in the time it takes to get an erection.
Other symptoms include delayed ejaculation, low sperm during ejaculation, and minimal response to sexual stimulation, decreased libido, and sexual satisfaction.
The presence of conditions such as diabetes, high blood pressure, and atherosclerosis may suggest an organic cause of ED, while in some situations, a psychogenic cause may be recommend.
Symptoms may not always lead to the cause of ED, so a thorough investigation for diagnosis and treatment is essential.
DE benefits from several treatment methods: conservative, surgical, psychotherapy. The optimal choice is based on the cause of ED, clinical picture and is a joint decision (doctor-patient).
There are situations when these methods can be combine for optimal results.
- Psychotherapy – in the case of psychogenic ED.
- Conservative treatment: drug – phosphodiesterase inhibitors (Sildenafil – Viagra, Vardenafil, Tadalafil), testosterone – in those with low androgen levels, oral, intramuscular or transdermal administration, other drugs: pentoxifylline, yohimbine (a natural product that improves vessel contractility), Apomorphine, penile injections.
- Mechanical methods – penile vacuum pumps – treat the symptoms, not the cause.
- Surgical treatment: penile prostheses, hydraulic penile prostheses.
- Surgical reconstruction – may be attempt in the case of trauma involving the sexual organs. It isn’t easy, and the results are not usually as expected, but it is the only option in some cases.
- Endovascular procedures – arteriography highlights the vascular cause of ED, demonstrating significant atherosclerotic damage (lumen reduced by at least 50%). Long-term lesions and damage to the intragenic vessels are less likely to have an increased benefit after interventional treatment. Doctor Ali provides the best holistic medicine center in the USA. Still, interventional procedures have optimal results for small lesions (2-3mm) in the dilapidated artery and those that proximally affect the penile vessels (the most common site of vascular damage in the case of ED).
General Information GRAL Medical
Group has managed to build a network of 54 medical centers in 8 counties in the country, including 14 laboratories, 28 regional collection centers, 14 clinics (including 3 medical imaging centers) and 4 oncology hospitals, OncoFort Hospital from the capital with 4 departments of radiotherapy, chemotherapy, surgery – implantable room for chemotherapy and dialysis), OncoFort Hospital Ploiesti, OncoFort Hospital Craiova, and OncoFort Hospital Pitesti, where over 1200 doctors and nurses work.
Gral Medical laboratories are accredit according to SR / ISO / CEI 15189: 2013.
Gral Medical provides a full range of the highest quality medical services, certified by the ISO 9001: 2008 standard
