Erectile dysfunction is one of the most modern diseases affecting the young male generation in the 21st century. The basis of the pathogenesis of the disease is a violation in the process of maintaining an erection.
Physiological erection is a psychogenic process. It occurs as a result of irritation in the brain, which is transmitted through the plexus of the spinal nerves, where the center of erection is located and triggers the mechanism of excitation and erection.
An erection is a process that is triggered by the neurohormonal pathway. This is done through some kind of visual or auditory stimulation in the brain, as well as sexual fantasies, regardless of whether there is a parallel bodily stimulation of the penis at the time. In these cases, certain specific areas of the brain begin to get excited. In turn, these special centers begin to send a signal along the efferent nerve pathways to the tissues of the penis, increasing its blood supply, which ends with the necessary hardness of the penis and the appearance of an erection.
Normally, after strong arousal and the onset of an erection, after an orgasm, processes of relaxation and cessation of erection occur. Also, “detection” can occur in some other conditions, such as stress, disease processes, high blood pressure, diabetes mellitus, hormonal imbalances in the body, vascular insufficiency and old age.
According to modern statistics, 3% of Bulgarian men suffer from erection problems. Of the total number of patients, about 5% are boys aged 20 to 30 years, with the majority of patients aged 50 to 70 years. In the past, the causes of these disorders were thought to be purely psychological. Today it is known that many organic causes occupy an honorable place in the genesis of this disease, and more precisely in middle-aged and elderly people. According to specialists in the field of sexual medicine and andrology, in a larger percentage of men suffering from erectile dysfunction, often the leading cause is not impotence, but cardiovascular disease.
According to modern grounds for assessing provoked erectile dysfunction, the leading cause of the development of the disease is damage to the brain or spinal cord in certain neurological diseases, hemorrhages, ischemic strokes, as well as any other incidents in the brain. The disease can also develop as a result of many other diseases of the peripheral nervous system, diabetes mellitus, vascular disorders of the penile blood supply, or hormonal disorders that occur with hypothyroidism, as well as hypotestosteronemia, in which the level of naturally produced testosterone in the blood falls.
What are the main differences indicating erection problems?
According to modern data from the journals of many andrological studies, a normal erection is assessed according to several criteria. It should start suddenly and the penis should be completely filled with blood, there should be no fear of possible achievements, a good morning and night erection should be maintained, there should be no psychological problems with a partner and there should be no problems, on a psychological level, at the beginning of sexual life.
Organic problems leading to the loss of the possibility of erection are the lack of normal sexual development, decreased libido, lack of morning and night erections, and the appearance of any factors that damage the genital organ at the organic level, which affects its blood supply and the onset of erection. stages, with slow and gradual blood supply to the penis.
For the correct diagnosis of the disease, sexologists and andrologists must conduct a very thorough and scrupulously collected anamnesis regarding the patient’s sexual history. In addition, a general clinical examination of the genital organs, as well as some laboratory tests, should be carried out. Under these conditions, the main laboratory tests are complete blood count, urinalysis, and blood sugar levels. In this way, the possibility of infection and inflammation along the urinary tract is checked, as well as some specific data on blood damage. Urinalysis indicates the normal anatomical and physiological function of the prostate and checks for bacteria or ulcers along the course of the urethra.
Blood sugar is of particular importance in the early prevention of diabetes mellitus and clarification of the possibility of its presence since diabetes mellitus is the leading provocateur of erectile dysfunction in men. Other important laboratory tests are monitoring the levels of male sex hormones, prolactin, keratin, thyroid hormones, and the overall lipid profile. Also, for additional diagnostic clarification of the organic causes of the lack of erection, pharmacocavernometry can be performed, which monitors the conductivity of cavities and their ability to fill, as well as a color Doppler test, which is a type of ultrasound following. a method for clarifying the system of blood supply and blood outflow of the penis.
What is the best treatment for these problems?
In modern medicine, there are many methods of treating erectile dysfunction. Psychosexual therapy is recommended for psychogenically stimulated erectile dysfunction. In addition, for some infections placed inside the penis, oral treatment, and transsexual therapy may be used. In organic forms of the disease, various types of intrapenile therapy, tablet treatment, intraurethral suppositories, hormonal regulation, and surgical repair of birth defects are used. Recently, the installation of implants with the help of plastic surgery is gaining momentum.