DISEASE IMPOTENSI
DEFINITIONS
Impotence (Erectile Dysfunction) is the inability to initiate and maintain an erection.
CAUSE
Impotence is usually the result of:
# Abnormalities of blood vessels
# Disorders of innervation
# Drugs
# Abnormalities of the penis
# Psychological problems that affect sexual arousal.
Cause physical is more common in older men; while psychological problems are more common in younger men.
Increasing the life of a man, it is increasingly frequent impotence, although impotence is not a part of the aging process, but the result of a disease that is often found in the elderly.
Approximately 50% of men aged 65 years and 75% of men aged 80 years experience impotence.
In order to erect, penis requires adequate blood flow. Therefore vascular disease (eg, atherosclerosis) can cause impotence.
Impotence can also occur due to a blood clot resulting from surgery or blood vessels that lead to the disruption of arterial blood flow to the penis.
Nerve damage leading to and leaving the penis can cause impotence.
This nerve damage can occur due to:
# Injury
# Diabetes mellitus
# Multiple sclerosis
# Stroke
# Drugs
# Alcohol
# Diseases lower spine
# Rectal or prostate surgery.
Approximately 25% of cases of impotence caused by drugs (especially in older men who consume lots of drugs).
Medications that can cause impotence are:
- Anti-hypertensive
- Anti-psychosis
- Anti-depressants
- Sedative
- Cimetidine
- Lithium.
Sometimes impotence occurs due to low testosterone levels.
But the decline in levels of male hormones (which tend to occur due to aging), usually more often causes a decrease in sexual desire (libido).
Several psychological factors that can cause impotence:
# Depression
# Anxiety
# Guilt
# Fear of intimacy
# Indecision about sex.
SYMPTOMS
Patients are not able to start and maintain an erection.
DIAGNOSIS
Diagnosis based on the symptoms.
Physical examination is done to look for any changes in male sexual characteristics, such as breast, testicles and penis size, as well as changes in the hair, voice and skin.
To determine abnormalities in the arteries in the pelvis and groin (which supplies blood to the penis), the measurement of blood pressure in the legs.
Other tests that may need to be done:
# Blood tests complete
# Examination of blood sugar for diabetes
# The level of TSH
# USG penis.
TREATMENT
Impotence can usually be treated without surgery.
The type of treatment depends on the cause.
Special exercises performed by patients with impotence due to psychological problems, namely the so-called 3-phase Mechanical centering sensation.
This technique encourages intimacy and emotional warmth, which is focused on building a relationship:
1. Phase I: courtship, the couple concentrate to please each other without touching the pubic region.
2. Phase II: the couple began touching the pubic region or other erotic areas, but not the act of intercourse.
3. Phase III: the act of intercourse.
Each achieve comfort at each stage of intimacy before continuing to the next stage.
If these techniques are not successful, the patient may need to undergo psychotherapy or sexual behavior therapy.
If patients are depressed, may be given antidepressants.
Sildenafil is a drug that can meningkatkanaliran blood to the penis.
This medication taken 30-60 minutes before sexual intercourse, is only effective if accompanied by sexual arousal.
Should not be taken together with nitrates because it can cause serious side effects.
If impotence or loss of sexual desire occurs due to low testosterone levels, patients should undergo hormone replacement therapy.
Testosterone is injected every week or given in the form of plaster.
The side-effect is an enlarged prostate and an excess of red blood cells that can cause a stroke.
Fastener or suction tool is often used to achieve and maintain an erection, but this tool should not be used by people with bleeding disorders or patients who take anticoagulant drugs.
Tool binder (a rope or ring made of metal, rubber or leather) mounted at the base of the penis to slow the flow of blood from the penis.
Vacuum (in the form of a hollow box and pump) is mounted on the penis. Vacuum pressure helps blood flow into the penile arteries. When the penis is erect, a fastener tool installed to prevent drainage of blood from a vein. The combination of these two devices can maintain an erection for 30 minutes.
Sometimes tool fastener causes problems when ejaculation, especially if tied too tight. For the sake of security, preferably after 30 minutes the device is released.
If overused, the suction device may cause bruising.
Impotence can also be treated with an injection of a special medicine that done by the patient.
This drug is injected directly into the erectile tissue of the penis (corpus cavernous. Erection occurs within 5-10 minutes after the drug is injected and can last for 60 minutes.
The side effects are bruised and sore. In addition, the injection can also cause priapism (persistent and painful erection).
If impotence does not respond to various treatments above, can be done transplant penis or use a prosthesis (an artificial penis).
One of the tools that transplanted stem stocky form inserted into the penis to produce an erection that is settled. Other tools in the form of a balloon that is inserted into the penis and inflated before the patient had sexual intercourse