Система Orphus

Symptoms of disease - violation of erectile function

Violation of the erectile function still consider psychological or age problem. Its prevalence has almost twice the frequency of coronary heart disease. Among the 40-year-old males 5% complain about the complete and 17% for moderate erectile dysfunction, which defines the most important socio - economic importance of its diagnostics and therapy. New diagnostic opportunities sharply changed the understanding of the physiology and pathophysiology penis and weakened bans on the discussion of this topic.

Today almost in 50-80% of cases of violations of the penis reveal the underlying organic defects. However, in the pathogenesis of each of such cases involved and psychological component. With the expansion of knowledge about the causes of violations of the penis there are new methods of pathogenetic therapy.

Physiological studies have shown that penis occurs as a result of dilation of the arteries, spasm of the veins and relaxation sinusoids cavernous bodies of the penis. Arteries, veins and sinusoids cavernous bodies are composed of smooth muscles, and muscles are tissues-tee for neurotransmitters that are emitted when the stimulation of the nerves that control the process of the penis. After the sexual stimulation neurotransmitters causes relaxation of smooth muscles of cavernous bodies of the penis, the expansion of sinusoids and the arteries feeding the body, and a great increase in blood flow into sinusoids. Then sinusoids are filled with blood, expand and compress the draining their venules, which causes a delay of blood. As a result of the reduction of ischio-cavernous muscle pressure inside the bodies of the penis up to 100 mm Hg.

Penis depends on the anatomical structure of the penis (such as, the elasticity of the eyelids liner shell), structure of vessels and nerve conduction. Decreasing of voltage of the penis usually occurs after a significant release of sympathetic mediators in combination with the reduction of the arteries of the bodies of a sexual member, reduction of the volume of blood flow and decompression drainage veins. Diseases that affect the protein shell and the surrounding tissue are associated with the loss of obturator the ability of local venous system, which results in blood't hold it inside the cavernous bodies. Similarly replacement of the smooth muscles sinusoids collagen leads to a loss of contractile ability and related erectile dysfunction. Reduce the penis also atherosclerosis or vascular lesions, caused by surgical intervention or injury of the pelvis.

Assessment of the erect penis

The major items of the evaluation of erectile dysfunction is assembled in detail medical history and complete physical examination, performed by the friendly, professional and understanding of the problems of the patient.

The presence of the sexual partner during a conversation, it is desirable, as the expression on her face can give the doctor the key to understanding the real state of Affairs. During the interview the patient can tell about the difficulties associated with the creation or maintenance of the penis. Here very it is important to determine: lost if the patient sexual desire, whether it has a place of premature ejaculate, retrograde ejaculate, deferred orgasm, or he is not able to obtain or maintain a satisfactory erection of penis.

After the patient has found a violation of the penis, important to determine the duration and degree of achieved penis. If dysfunction was growing gradually, it is an organic etiology. It is also important to establish, it is noted whether the violation of the penis in communicating with all sexual partners or only with his wife, if the problem is fixed or occur periodically, as well as if there is still some additional factor provocateur.

You should find out:
- Received if the patient treatment for the matter;
- Can it cause long penis through masturbation;
- Notes whether he availability of night erections;
- Are there the morning difficulty with urination.

If the answers to these questions are positive, the patient, most likely, a psychogenic erectile dysfunction; but in some cases, for example, when injury of nervous stem, located on the dorsal surface of the penis, penis in the patient may occur if the Central or visual stimulation, but will not be available when performing sexual intercourse.

In other cases, the patient may be normal night penis and penis, associated with sensual impressions, but the rigidity of the penis falls by frictions during sexual intercourse due to the syndrome of «pelvic victimize». This situation arises in case of partial occlusion of blood vessels above the bifurcation iliac artery, as a result of the peace of blood flow through a. Pudena and a. dorsalis penis remains adequate, but during frictions arise shunting of blood from a. Dorsalis penis in the gluteal the vessels, and the erection of the penis is reduced.

Asking the patient, is not reduced if the penis when energetic movements of the pelvis during sexual intercourse, the doctor can get the key to the understanding of the problem. Having found, it is noted whether the patient peremejatayasa limp, you can also evaluate the intensity of local blood flow. Curvature of the penis, the decrease of its length, the pain in penis presuppose the presence of the patient Peyronie's disease.



Which diseases there is violation of erectile function

Cause of erectile function may be psychogenic, vascular, neurogenic, hormonal or biogenic violations, as separately, and in different combinations. New diagnostic methods in the radically changed the old idea of predominantly psychogenic violations of the penis. These methods allow to objectively and quantitatively examine the various mechanisms of the emergence and maintenance penis. Despite all this the role of psychogenic component cannot be ignored: it is present in all cases of prolonged violation of erectile function.

Psychogenic disorders of erectile function
Psychogenic factors, such as visual or auditory images, serve as powerful inductors of the penis. On the contrary emotions such as fear or the memory of a previous bad experiences, can to some degree or another disrupt the ability of the penis. The causes of primary violations often lie in the social sphere and education. Secondary disorders usually occur acutely and depend on the specific situations or from a partner. In such cases, there are often other signs of sexual violations. Prognosis and therapy of erectile dysfunction in many respects depends on that, is it linked to the weakening of sexual desire, or with the fear of failure or some psychological difficulties. The weakening of libido (sexual desire) can have organic causes, but more often connected with the peculiarities of the partner and therefore has a relatively poor prognosis.

Violations of the erectile function of vascular Genesis
For the physiological penis need two factors: sufficient inflow of arterial blood to the cavernous bodies and functioning mechanism of their occlusion. Therefore, differentiated, and two types of vasculogenic erectile dysfunction: due to the decrease of the arterial inflow and because of violations of the mechanism of occlusion cavernous bodies. Erectile dysfunction organic Genesis in the 50 - 80% of cases is due to the insufficiency of the arterial blood supply to the penis. Risk factors of atherosclerosis development and, as a consequence, erectile dysfunction, are addicted to the nicotine, arterial hypertension, diabetes mellitus or breach of lipid exchange. And also one should take into account the possibility of injury pussy with damage of vessels, as well as iatrogenic causes (operations on the vessels or organs of the pelvis).

Neurogenic disorders erectile function
Erectile dysfunction accompanies many types of nerve pathology. Most often this occurs in the event of damage of the spinal cord. Reflex penis is saved in about 95% of patients with damage to the upper part of the spinal cord and only in 25% of the damage sacral. In such systemic diseases as Parkinson's disease, multiple sclerosis, inflammatory and neoplastic lesions of the Central nervous system, erectile dysfunction is often associated with the violation of the balance between stimulating and slow down influences.

Violations of the erectile function of endocrine Genesis
The role of androgens in the regulation of the erectile function clear enough. At low levels of testosterone are often noted the weakening of libido, a drop in the production of sperm and decrease the exact erection.

Heavy androgenic insufficiency by definition is characterized by low levels of testosterone, but erectile dysfunction is very rarely the first sign of hypogonadism. When androgen deficiency decreases the number of NO-containing nerve fibers and enhanced apoptosis of smooth muscle cells, which should break the transfer of regulatory signal cavernous bodies. One way or another, endocrine factors lie at the basis of violations of the penis no more than 2-5% of patients.

Violations of the erectile function, caused by drugs
Among the causes of erectile dysfunction significant place is occupied by reception of various kinds of drugs. In most cases they act on the Central nervous system, changing the state of the hypothalamic-pituitary-gonadal axis, or the Autonomous nervous system. Excessive alcohol consumption not only causes polyneuropathy, but also reduces testosterone levels due to violations of the liver and secondary improve the content of estrogen.



Which doctor should I contact if there is a violation of erectile function

  • Urologist
  • Endocrinologist
  • Psychiatrist


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Do you feel disrupted erectile function? You should be very careful approach to your health in general. People pay not enough attention to the symptoms of the disease and don't realize that these diseases can be critically dangerous. There are many diseases that in the beginning didn't manifest in our body, but in the end it turns out, unfortunately, it have already been treated too late. Every disease has its own specific features typical symptoms - called symptoms of the disease. Definition of symptoms is the first step in the diagnosis of diseases in general. You just need a few times a year to be screened by a doctor, not only to prevent a terrible disease, but also to maintain a healthy spirit in a body and the organism in general.

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Map of the symptoms and the types of disorders is intended solely for educational purposes. We strongly recommend do NOT self-medicate; on all matters relating to the definition of the disease and ways of its treatment, contact your doctor. Md-tips is not responsible for the consequences of use information posted on the site.