Forms of Ed

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by: SyefanVijjan
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Word Count: 1181
Date: Mon, 31 Jan 2011 Time: 3:02 PM
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Impotence can be of several types:

Arteriogenic: This form of impotence is when the arteries that supply the penis with blood can't deliver sufficient blood to cause or sustain an erection. This can occur because of a narrowing of the arteries such as occurs in the elderly, diabetics and those with high blood pressure or because of injury to the genital region which causes a block in the artery to the penis. The latter description is more frequent among younger patients. Injuries that can cause problems may stem from major incidents, such as fracture of the pelvis or pubic bone, or stem from minor injuries, such as bicycle riding that may crease a clot, or thrombus, within the artery leading to the penis. Clots such as these are capable of continuing to grow until they block the penis' blood supply altogether.

Recently, it's been recognized that signs of erectile dysfunction in men can serve as a warning for future cardiovascular diseases, such as heart attack or stroke. It's been noted that arterial diseases can often affect smaller arteries, such as within the penis, before affecting much larger arteries, such as within the heart or brain. This should be a strong argument for the benefit of having erectile dysfunction diagnosed and treated early, as medical specialists can then help to detect any early warning signs of other problems developing, such as diabetes, high blood pressure and others.

One case study shows a 23 year old student became completely impotent after sustaining injuries in a car accident, where he fractured his pelvis and ruptured the urethra. The patient was admitted to hospital for almost four weeks and underwent an operation. Before the accident, he had had a normal sex life with his fiance. Upon returning to the doctor who treated the original injury, the patient was told that his erectile problem was psychological and that it should resolve in a couple of months. After a year with no improvement, the patient was seeking to end his engagement. It was only after reading a magazine article that prompted him to visit an andrologist. Using a phalloarteriogram, it was discovered that the artery to the penis was obstructed. The patient was finally cured with a microsurgical bypass operation - a penile revascularization procedure.

Arteriogenic impotence resulting from injuries is very common but often unsuspected because of ignorance of the causative conditions. It's common for patients to be wrongfully admitted to orthopedic or urology wards in an attempt to treat problems. It's often only after the original wounds or fractures are healed that any impotence problems are discovered. In these cases, the patient learns of the resulting impotence first, and not the doctor.

Venogenic: This form of impotence occurs when blood leaks from the penis, which prevents a fully hard erection from forming. In a male without this condition, veins within the penis shut down so that almost no blood can flow back out from the penis. This allows blood to accumulate in the sinusoids of the penis, thus raising pressure and allowing for the development of rigidity or hardness.

There is a very high occurrence of erectile dysfunctionm caused by venogenic impotence. It's believed that somewhere between 30 and 70% of all impotence problems may stem from this condition. Primary venogenic impotence afflicts men from the time they're born. These men have most likely never attained a hard erection in their lives. Yet secondary venogenic impotence may develop suddenly even after years of a regular sex life.

Neurogenic: The nerve system leading to the penis is enormously complex. A proper conduction of impulses along these is basic for the initiation and maintenance of an erection. It is these nerves that activate the arteries and the veins and alter the dynamics of blood flow within them.

There are plenty of things that may negative affect the nerve supply to the penis. Injuries to the back, especially if they involve the vertebral column and the spinal cord can cause impotence.

So also can injury to other nerves supplying the penis such as occurs after pelvic or perineal trauma. A wide variety of operations performed for other conditions can cause incidental injury to the nerves of the penis and cause impotence. These include procedures on the rectum, prostate, urethra, spine, retroperitoneum, urinary bladder and others.

There are also various disorders of the nervous system that involve nerves to the penis and can cause erectile dysfunction, such as multiple sclerosis, myelitis, and tumours.

Another such afflication that can negatively affect the nerves to the penis is diabetes mellitus. Impotence is a very common complaint among patients with diabetes. In fact, as many as 50 per cent of all diabetics are impotent. Impotence in diabetics is almost always organic in origin. Appropriate therapy for diabetes can never restore erectile function because the basic diabetic process can never be reversed. Unfortunately, diabetic treatments tend to only control the blood sugar levels and little else. Yet andrology is able to treat, and in many cases, cure patients suffering from diabetes-related impotence. Once again, this is largely an unknown fact. Very few diabetologists offer their patients a way to treat the resulting erectile dysfunction their diabetes could be causing.

Some drugs may also be responsible for causing neurogenic impotence as they damage or otherwise affect the nerve endings. Among the primary culprits are anti-hypertensives used to reduce blood pressure and psychotropics. Yet the number of drugs in this category is extensive. Most doctors will remain completely oblivious to the fact that the drugs being prescribed to treat various ailments could be the culprit for causing impotence as a side effect.

Endocrinologic: Endocrinologic, or hormonal impotence, will occur if the patient has a hormonal imbalance or lack of sufficient sex hormones in the blood. It is believed between 5-10% of organic impotence cases come under this category. Generally, hormonal changes affect the libido (or sex drive) rather than the quality of the erection per se. A variety of disease conditions can cause these changes.

Mixed: In some patients, there may be multiple factors at work causing impotence. Systemic disease is usually the common denominator with these patients. Notable examples are diabetes, kidney failure and liver failure.

Mixed factors can also lead to the onset of secondary disorders, such as depression. Here, the basic causative factor is organic but being unrecognised and untreated (or maltreated) it eventually takes its toll on the mind, often because the patient thinks or has been led to believe that the condition is incurable and that it's all in his mind.

Psychogenic: Of course there is still a very small percentage of men where the problem really is within the mind and is labelled psychogenic impotence. But before such hasty labeling it is necessary to prove by andrological investigation that no organic or bodily cause exists.

Once this has been done, treatment can commence specifically to treat the problem found.

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