What is Erection Problem? Erection Problem Symptoms, Diagnosis and Treatment

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Male sexual function problems from frequent erectile dysfunction, is a condition in men avoid stiffness to provide sexuality.

What is Erection Problem? How Often Is It Seen?

Erectile dysfunction is also called impotence, and it is the event that a man cannot reach and / or maintain sufficient penile erection (hardening) for sexual performance, either continuously or repeatedly. It is not a life-threatening disease, but it negatively affects your partner’s and your quality of life.

It is quite common in society. There is over 50% probability for a man to experience erectile problems throughout their life. Its incidence increases with increasing age. Considering all age groups in scientific studies, it is seen at a rate of 31%.

How Does Erection Happen?

sertleşme sorunu

For erection to occur, the hormonal, vascular and nervous systems should be intact, the integrity of the penile tissues should be intact, and there should be no psychogenic problems.

Visual stimuli, sexual fantasies, or tactile stimuli increase biochemical substances such as nitric oxide.

Due to the relaxation of the muscles in the penile vessels, the penis begins to grow and thicken. Due to the increase in stimulation, the muscles relax and the blood flow to the penis becomes maximum.

In this case, venous flow stops, and full erection is achieved and the penis is ready for sexual intercourse.

After ejaculation occurs, the blood that comes to the penis and is trapped in the penis due to the opening of the veins begins to discharge. The smooth muscles in the penile vessels contract and the penis takes its original shape.

What Causes Erection Problem?

sertleşme nasıl olur

To have an erection, the structure of the entire system, namely the nervous, hormonal, vascular structures and forceps, which provides hardening from the brain to the penis, must be intact. As age progresses, deterioration in these systems is inevitable. The main reasons for impotence are;

  • Diabetes (diabetes)
  • High blood pressure (hypertension)
  • Hyperthyroidism / hypothyroidism (Goiter)
  • Andropause (hypogonadism), low testosterone hormone
  • High cholesterol
  • Cerebrospinal cord injuries
  • Lower abdominal surgery for prostate cancer, rectal cancer, bladder cancer
  • Some drugs used in blood pressure treatment
  • Diseases of the penis such as Peyronie’s disease
  • Vascular diseases of the heart
  • Smoking Cigarette

sertleşme sorunu neden olur

Diabetes mellitus is the leading disease that disrupts these systems. In diabetes, there are serious damages in both vascular and neural structures. In fact, diabetes can be detected in 10% of those who come with erection problem.

In current scientific studies, it has been reported that the penile vessels also started to become blocked 2 years before the heart vessels were blocked and there was an erection problem. Vascular stiffness and narrowing due to high cholesterol is also one of the causes of erection problem.

Erectile dysfunction may develop due to injury to the nervous system, especially in surgeries involving the pelvis (lower abdomen) or cerebrospinal cord. Erection may be impaired in diseases such as hyperthyroidism, hypothyroidism, and hypogonadism that disrupt the hormonal balance.

How Is Erection Problem Diagnosed?

sertleşme sorunu tedavisi

When diagnosing an erection problem, it is necessary to distinguish whether the distress is of psychogenic or organic origin. Severe depression, bipolar disorder, schizophrenia, and medications used for this reason should be questioned.

Systemic disease that may cause impotence, previous surgeries, medications used, and other existing diseases should be known in detail.

In addition, some international evaluation forms such as international erectile function form (IIEF) and clinical depression scale should be completed.

After a detailed physical examination, some biochemical analysis results such as basic fasting blood glucose, cholesterol, triglyceride, HDL, LDL, testosterone level when necessary can give us clues.

After evaluating the results of these, advanced examinations such as penile color Doppler ultrasonography, intracavernosal stimulation test, and cavernosometry should be performed and the result should be obtained.

How is the Treatment of Erection Disorder?

After questioning, physical examination, laboratory analysis and special tests, if the patient has psychogenic erectile dysfunction, the psychiatrist can be asked for help. However, the majority of erectile dysfunction is due to organic reasons.

First underlying diabetes, heart disease, gout, hypertension, and should be corrected if some conditions such as certain hormonal disorders. If the patient is overweight, lifestyle changes, smoking cessation and exercise have a positive effect on sexual function. Erectile dysfunction treatment is carried out in 3 stages.

  • First, if the lifestyle change does not improve with or afterwards, drugs such as sildenafil, vardenafil, tadalafil, avanafil that increase the blood supply of the penis, namely Viagra, Cialis, Levitra can be given. If the situation with these is good, the treatment is continued with these drugs as long as the patient wishes.
  • If the drugs that increase penile blood supply are not sufficient or if there is no response to the drug, further tests such as Penile Doppler ultrasonography and intracavernosal tests are performed. If there is a response to the intracavernosal test, the patient is given papaverine/regitin and prostavasin mixture (trimix) treatment. Patients make trimix injections into their penises 15-20 minutes before the intercourse, just like diabetics make themselves insulin.
  • If there is a serious erection defect in advanced tests and there is no response to the above treatments, that is, if there is no response to medical treatment, then surgical treatment and erection problem treatment is required. In surgical treatment, if there is not enough blood to the penis and there is a circulatory defect, if the patient is younger than 40, blood-bearing operations can be performed. If there is a venous leak, the veins that drain the penis can be connected. If the patient is over 40 years of age and has erectile dysfunction that does not respond to treatments, the last thing to be done is the penile prosthesis, the happiness stick, is the gold standard in treatment. Penile prostheses are available in one-piece (malleable), two-piece and 3-piece types.

When diagnosing and diagnosing erectile dysfunction, we first take a good anamnesis from the patient. So we talk to the patient. Whether there are some factors that cause this, it is investigated thoroughly. After that, some blood techniques are done.

A number of tests are made regarding cholesterol and sugar. Then, research is done on whether there is enough male hormone or not. In other words, the patient’s hormone profile is checked. Then we can do some tests.

We can diagnose erectile dysfunction by looking at some conditions, such as whether the system is intact or not providing enough blood with an intracavernous injection, one of which is a needle into the penis.

Erectile dysfunction symptoms; Inability to obtain enough hardness of the penis despite the wishes of partners or spouses. Even if the hardness is obtained, we can say that failure to maintain this event is again the symptoms of erectile dysfunction.

In other words, we can say that there is not enough hardening despite the desire for hardening and that it cannot continue this hardening.

Erectile dysfunction can be prevented by taking some precautions. At the same time, it would be more correct to say that we can delay it. It is necessary to take some precautions for this. One of these may be psychological considerations.

What are these? Here’s how to overcome some of the problems that make us depressed. Apart from that, if some precautions need to be taken, it would be best to get help from a psychiatrist.

On the other hand, when we look at the organic reasons, some measures can be taken here as well. One of them is exercises. Regular exercises are important.

It is important not to gain weight. In terms of hormone balance, exercise provides a very important regulation. Here again, whether there are hormonal disorders or weight gain, these are also one of the most important causes of erectile dysfunction, so we can cause this disorder later by getting these reactions.

On the other hand, some measures can be taken to protect the nerves that provide hardening in surgical procedures. In surgeries, it should be evaluated in terms of the presence of erectile dysfunction and some measures should be taken to prevent it. Apart from this, if there are certain diseases such as diabetes and blood pressure in terms of hormonal factors, it may be necessary to treat these chronic diseases again in terms of erection problem measures.

If there is cholesterol, it is also important to regulate it. In other words, if there are metabolic factors, I think that eliminating these metabolic factors may be very important in terms of preventing or delaying erectile dysfunction.

Among the physical causes of erectile dysfunction, we can say the following basically. Diabetes is one of the most common causes.

Since diabetes affects both the nervous system and the vascular system as well as the whole system and metabolic factors, we can count it as one of the main causes of erection problem.

Apart from that, the reasons we call hormonal factors, namely endocrinological factors; Hyperthyroidism, hypothyroidism, that is, less or too much work of the thyroid gland can cause erectile dysfunction. In addition, other endocrinological reasons can also cause erectile dysfunction.

Another reason is previous surgeries. Prostate surgeries, previous surgeries related to the colon, and other surgeries related to the uterus if a woman may also cause sexual dysfunction in women. Surgeries are an important part here.

There are basically two reasons for erectile dysfunction. The first is psychological reasons and the other is organic reasons. You can’t find any organic reason for psychological reasons.

Apart from this, some problems such as severe depression or psychoses are defined as psychological causes of erection problem. For psychological reasons, it is necessary to get help from psychiatrists. Organic reasons are also the job of urologists.

Prof. Dr. Abdullah ArmağanUrology Specialist

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