Characterize by the inability to develop or maintain an erection of the penis during sexual activity in human. Which can be found up to 40 percent in males aged 40 – 70 years old, but with just a minimal number of patient who dare to consult with a physician.
Risk Factors and Causes of Disease
- Age (the older the individual gets, it affects the level of hormone in the body Testosterone).
- Fewer times or lack of morning erection.
More than 50 percent of men having Chronic disease suffers Erectile Dysfunction ; ED
- Diabetes Mellitus, Diabetic Neuropathies.
- Hypertension , Heart disease can cause decrease blood circulation.
- Prostate cancer and BPH
- CKD (Chronic kidney disease)
Behavior and life styles habit
- Less exercise
- Not enough rest
- History of Operation e.g. Prostate operation
- Psychiatric Medication
- Stress anxiety during intercourse can contribute 10-20 percent to the cause of E.D.
How to diagnose
- Access for past medical and family history
- Physical examination
- Lab chemistry test including testosterone and PSA level
- reduce risk factors, life style modification, disease control and prevention, maintain good exercise and enough rest.
- reduce stress and increase confidence and seek further counseling as necessary.
- Treatment by Medication
– PDE5 inhibitor, Viagra ( Sildennafil ), Levitra ( Vardenafil ), Cialis ( Tadalafil )
– Take medication 1 hour before sexual intercourse.
– The medication causes smooth muscle relaxation and increased blood flow into the penis causing penile erection.
– The medication is contra indicated with patient taking nitrate and on hormone therapy (Testosterone).
– Injection direct to the penis (papavarine, alprostadil)
- Vacuum device
- shock wave has angiogenic properties and stimulates neovascularization there for can improve penile blood flow and endothelial function.
- Operation considered as the last treatment option by prosthesis insertion. Two types 1. Malleable penile prosthesis 2. Inflatable penile prosthesis