Impotence

Impotence is a phenomenon of impaired potency, also known as sexual impotence. This means that a man is not capable of performing sexual intercourse. Often impotence is a symptom of some other, more general disease. Accordingly, sexual impotence can be eliminated by curing the underlying disease. In addition, impotence is often a manifestation of psychological problems, for example, depression, a complex due to disharmony of relationships within the family or between sexual partners.

The content of the article:
Physiology of erection and detumescence
Signs of the disease of sexual impotence
Diagnosis of impotence
Treatment of impotence
Impotence
Impotence in men is manifested by psychological discomfort during sexual intercourse, the inability to achieve a full erection.

Treatment of impotence is not a problem at this stage of medical development, since this disease has been well studied by specialists and is successfully cured.

Physiology of erection and detumescence
The main organ responsible for a man’s sexual health in this case is the smooth musculature of the cavernous tissues, as well as the walls of the arteries and arterioles. After all, they are responsible for the occurrence of a full-fledged erection and for its decline after the release of seminal fluid or other events that prevented sexual intercourse from ending naturally.

The calm state of the smooth muscles of the penis is carried out by the influence of sympathetic nerve endings. When sexual arousal occurs, the parasympathetic nerve endings transmit impulses, which is why the neurotransmitters of erection are released, and the cavernous bodies of the penis are filled with blood. Erection is a complex chemical process that always involves participation in the nitric oxide reaction and includes several stages. In order for the cavernous bodies to fill with blood, the penis must go through the first stage of complete relaxation of smooth muscles. The penis begins to increase in size from the influx of blood, which causes the cavernous bodies to partially block its outflow. Rigid erection increases with the increase in pressure caused by the difference in the inflow and outflow of blood.

Detumescence is the reverse process that begins after the termination of sexual stimulation of the penis or ejaculation of seminal fluid, and is the activation of synaptic structures, the release of norepinephrine and neuropeptide.

The process is controlled by the brain, namely, its middle preoptic cortex. The sexual behavior of a man in general largely depends on the amount of dopamine-like substances that are responsible for stimulation and on the volume of seratonin-like structures that suppress the process. If there is an imbalance in any of the listed structures, the amount of substances, hormonal background, then impotence occurs.

Signs of the disease of sexual impotence
The pathogenesis of sexual impotence can be different, which makes it possible to distinguish several types of this disease. So, doctors distinguish:

Psychogenic impotence — temporary or permanent. Occurs in men who are constantly subjected to heavy physical exertion or mental work, have all the signs of overwork, notice psychological difficulties with choosing a partner. Normalization and general improvement of a man’s way of life can eliminate psychogenic impotence.
At the heart of this type of disease is a decrease in the sensitivity of the cavernous tissue to the secreted neurotransmitters, which is due to the fact that the cerebral cortex produces an overwhelming effect. It is also possible to disrupt the spinal nerves, which is, in turn, a symptom of sexual deviations, complexes, phobias, mental trauma, religious beliefs. The development of diagnostics at the moment allows us to say that psychogenic impotence in its purest form, which occurs with the most serious sexual deviations — for example, such as bestiality — is very rare.
Another type of impotence is called neurogenic, which fully describes the cause of this type of sexual infertility. This includes problems and diseases of the central nervous system, injuries of peripheral nerves. Neurogenic abnormalities do not allow nerve impulses to pass into cavernous affairs. Among the most common neurogenic problems that cause impotence are spinal cord injuries, cerebrovascular pathologies, multiple sclerosis, syringomyelia, herniated disc.
Arteriogenic impotence is an age-related type of the disease, since changes in the work of both coronary and penile vessels are almost the same. Arteriogenic impotence may also occur at an early age, which happens most often due to smoking, hypertension, diabetes or congenital vascular problems. The problem with sexual potency arises here due to the fact that the vessels do not provide normal blood flow to the cavernous body, which means a rapid metabolic disorder and disorders of this part of the organ.
Venogenic impotence — remains partially unexplored for specialists, but it is known for sure that its cause is a violation that manifests itself in the venous bloodstream. This means an increase in the lumen of the veins. The cause of such problems may be a traumatic rupture of the venous membrane, which occurs during ectopic drainage of cavernous bodies by penetration through the vessels. In turn, insufficiency develops, and venogenic impotence can also be accompanied by problems with cavernous tissue, Peyronie’s disease. The situation can be aggravated by the abuse of narcotic substances, smoking, alcohol.
Hormonal impotence is often a symptom of diabetes mellitus, since it is this disease that causes severe changes in the tissues of the penis and human blood vessels. It is not the general change in the hormonal background that is more important here, but the difficult assimilation of the hormone testosterone.
Other causes of impotence disorders include cavernous insufficiency, dysfunction of this penile tissue, changes in the structure of cavernous bodies, blood vessels. Kidney diseases, or problems after kidney transplantation, may also be of great importance. Experts point out that after transplantation of this organ, two thirds of patients experience major problems with erection, but this problem is reversible.

Prostatitis is also the cause of sexual impotence, since it causes a violation in the hormonal background of the patient, namely, a lack of testosterone in the blood.

Circulatory mental disorders are singled out separately as the cause of impotence. These include psychogenic problems — soreness during ejaculation of seminal fluid, premature ejaculation, failure syndrome.

Thus, it is possible to understand what causes impotence may have, signs of the disease and its development should be observed by a doctor for the correct diagnosis of the above types of pathogenesis, on which the prescribed treatment and its success and effectiveness directly depend.

Diagnosis of impotence
The purpose of diagnosis is not so much to identify the disease itself, but to determine the cause of its occurrence, since it can be very different, and, in addition, sexual impotence itself sometimes serves as a manifestation of a more serious disease. The effectiveness of the prescribed treatment and the restoration of a man’s erectile function depends on the success and accuracy of the diagnosis.

So, the first stage of diagnosis is the identification of psychogenic or organic type of impotence. To do this, use a technique such as monitoring nighttime erections. In addition, the coverject test is also very indicative (it is also known as the intracavernous injection test).

When an organic type of sexual impotence is detected, a second series of medical tests and studies are prescribed, which are very diverse and aimed at identifying the patient’s health problems that can cause impotence.

Treatment of impotence
The modern process of impotence treatment is a very diverse set of techniques used to solve problems in all areas of the patient’s health. The decision on the appointment of a particular type of treatment should be made by a specialist andrologist, who necessarily takes into account the patient’s desire and ability to apply this technique.

Drug therapy is the most traditional method of treating impotence. Most often, it takes the form of substitution therapy, which means taking testosterone and andrenoblockers. In addition, an additional ointment application is prescribed, which can be performed with Trimipramine, Metachlorophenylpiperazine and other medications. There are known data on the effectiveness of such treatment — and they are not striking. Only 30% of patients who have chosen medication treatment report an improvement in erectile function. Based on these results, doctors do not prescribe medications to all patients.
Psychotherapeutic treatment is also used as the main technique in the presence of neurogenic and psychogenic impotence. The most important condition here is that all sessions should be carried out by a professional. Vacuum erectile therapy is also effective here, which shows high efficiency. With its proper administration and implementation, 83% of patients noted improvements, and side effects from its use number a few cases.
Intracavernous medical therapy is considered a relatively new method of treating sexual impotence. Initially, this method of solving problems with impotence used the drug papaverine, but later it was replaced with phentolamine, proglastadine E1 or other medications. Intracavernous medical therapy is characterized by minimal side effects for the patient, while its effectiveness is about 80%, which indicates a high probability of complete healing of the patient and his return to a full sexual life. The disadvantage of this method of treating sexual impotence is its relative soreness, however, an additional injection of 7.5% sodium bicarbonate is used to eliminate this effect. Now specialists are actively developing methods of intracavernous medical therapy, which would be carried out without injections at all, which would make the whole process painless.
Prosthetics is also carried out as a method of treating impotence in men. This method is called intracavernous falloprosthesis, it has been used since 1936. This technique became particularly widespread in the mid-70s. Modern methods of falloprosthetics make it possible to guarantee a full return to sexual life, since the prostheses used for treatment have the widest range of principles of action. Falloprosthesis is so effective that it is often recommended as the initial way to solve the problem. The number of complications after this operation does not exceed 4%, and its effectiveness is simply amazing. Often, falloprosthetics are chosen by those patients who were initially recommended to resort to drug therapy, psychotherapy, vacuum therapy, intracavernous injections. Among the indisputable advantages of this method of treating impotence is the absence of the need for constant medication, painful injections, as well as the naturalness of an erection and the complete restoration of the patient’s sexual life.
Impotence treatment includes a wide range of techniques that are aimed at eliminating problems in all areas of the patient’s health. It is worth noting the instrumental variety of ways to treat impotence, as well as the big leap that medicine has made in this regard. If an erection problem occurs, the patient should immediately consult with a specialist doctor – for example, an andrologist, for immediate identification and diagnosis of the causes that caused erectile dysfunction. Also, communication with the doctor will help you choose the best way to treat the disease, because it is very difficult to make a decision on your own, and this, of course, should be done by a professional and experienced medical worker.

Post Views: 499

Penile injuries

Injuries of the scrotum organs

Ureteral stricture

Most Popular

WHO: 1 billion people in the world are served by medical institutions without reliable power supply

Gastritis symptoms and what is it

Diarrhea

Rectal prolapse

Recent Comments