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Most men experience at least one episode
of erectile failure, defined as the inability to maintain an erection adequate for
intercourse, at some point in their lives. While erectile failure is common, it is
underreported to physicians. It is frequently present in people with diabetes but many
other causes are also possible.
Causes
1. Age (it is more common in older men)
2. Many drugs have been reported to cause erectile dysfunction.
3. Diabetes.
4. Vascular disease.
5. Endocrine disorders
6. Neurologic disorders
7. Urologic disorders such as inflammation of the prostate, inflamation of the urethra,
etc.
8. Systemic diseases such as liver disease, kidney disease, heart failure, etc.
9. Psychological disorders such as depression, anxiety, etc
Diagnosis and Physical Examination
1. A complete history should be obtained of the patient.
2. The physical examination should be performed in such a way as to exclude/confirm the
possibility of the above mentioned causes. Secondary sexual characteristics should be
examined (beard, body hair, and testicular size and consistency). The possible presence of
an enlarged breast should be examined. The penis should be examined for possible
abnormalities. The prostate should also be examined.
3. Serum testosterone should be measured. If testosterone is abnormal, other hormones may
also have to be studied. In addition, a standard blood test should also be performed to,
for example, exclude the possibility of diabetes.
Treatment
Treatment is based on the underlying cause of the dysfunction, the importance of the
problem to the patient, and his preferences about potential interventions. Including the
patient’s regular sexual partner in diagnosis and treatment planning helps to avoid
misinformation and inappropriate expectations. Although medical therapy has not been
successful in the past, a new drug by the name of Viagra has been recently introduced,
which can help patients with this problem. Penile prosthesis insertion by a urologist has
been the traditional surgical management.
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