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Methods of diagnosis

The Latin term for male impotence is impotentia coeundi which describes simple inability to insert the penis into the vagina. The medical condition is characterized by the regular or repeated inability to obtain or maintain an erection. Erectile dysfunction can be diagnosed by several methods. Duplex ultrasound is one of them and it is used to evaluate blood flow, venous leak, signs of atherosclerosis, and scarring or calcification of erectile tissue. Injecting prostaglandin, a hormone-like stimulator produced in the body, induces erection. Ultrasound is then used to see vascular dilation and measure penile blood pressure. Measurements are compared to those taken when the penis is flaccid.

Bulbocavernosus reflex test is used to determine if there is sufficient nerve sensation in the penis. The physician squeezes the glans (head) of the penis, which immediately causes the anus to contract if nerve function is normal. A physician measures the latency between squeeze and contraction by observing the anal sphincter or by feeling it with a gloved finger inserted past the anus. Specific nerve tests are used in patients with suspected nerve damage as a result of diabetes or nerve disease. Penile biothesiometry is a test which uses electromagnetic vibration to evaluate sensitivity and nerve function in the glans and shaft of the penis. A decreased perception of vibration may indicate nerve damage in the pelvic area, which can lead to impotence. Researches show that it is normal for a man to have five to six erections during sleep, especially during rapid eye movement (REM). Their absence may indicate a problem with nerve function or blood supply in the penis. There are two methods for measuring changes in penile rigidity and circumference during nocturnal erection: snap gauge and strain gauge. Penile Angiogram is an invasive test which allows visualization of the circulation in the penis and is used during the repair of a priapism. Dynamic Infusion Cavernosometry is a technique in which fluid is pumped into the penis at a known rate and pressure. It gives a measurement of the vascular pressure in the corpus cavernosum during an erection. To do this test, doctors inject a vasodilator like prostaglandin E-1 to measure the rate of infusion required to get a rigid erection and to help find how severe the venous leak is. Magnetic resonance angiography uses magnetic fields and radio waves to provide detailed images of the blood vessels. Doctors may inject a “contrast agent” into the patient’s bloodstream that causes vascular tissues to stand out against other tissues. The contrast agent provides for enhanced information regarding blood supply and vascular anomalies. Aside from the IV used to introduce the contrast material into the bloodstream, magnetic resonance angiography is noninvasive and painless. These days’ technology and fast growing needs of the population invent many other ways to diagnose male impotence. Increasingly examinations and test become more précised and describe the whole picture of the medical condition.

Treatment

Male impotence is as old as world that why you don’t have to worry about it. The earliest attempts at treating erectile dysfunction date back to Muslim physicians and pharmacists in the medieval Islamic world. Muslims were the first people who prescribe medication for the treatment of this problem. In fact, they developed several methods of therapy using drugs and food. Most of the drugs were oral medication, though a few patients were also treated through topical and transurethral means. On the other hand, erectile dysfunctions were being treated with tested drugs in the Islamic world since the 9th century until the 16th century by a number of Muslim physicians and pharmacists, including Muhammad ibn Zakarīya Rāzi, Thabit bin Qurra, Ibn Al-Jazzar, Avicenna (The Canon of Medicine), Averroes, Ibn al-Baitar, and Ibn al-Nafis (The Comprehensive Book on Medicine).

In the 1920s and 1930s some contribution was given by dr. John R.Brinkley who made a boom in male impotence cures in the US. His radio programs recommended expensive goat gland implants and “mercurochrome” injections as the path to restored male virility, including operations by surgeon Serge Voronoff. After half a century surgeons began providing patients with inflatable penile implants. In 1983 the British physiologist Giles Brindley demonstrated to American Urological Association audience his phentolamine-induced erection. Giles Brindley injected into his penis a non-specific vasodilator, an alpha-blocking agent. The effect that Brindley discovered established the fundamentals for the later development of specific, safe, orally-effective drug therapies.

After such spectacular discoveries now we have various treatments for curing erectile dysfunction. Each of them is appropriate for the concrete male problem and its causes. Some men need sexual counseling. Counseling and sex therapy are sometimes effective in helping patients with sexual problems, especially when caused by psychogenic reasons. Marital and personal counseling is targeted on interpersonal and relationship issues which contribute to resolving a couple’s or an individual’s psychological and emotional dysfunction. Oral treatment is another option. The patient has to take pills depending on the time when he wants to have sex. For example, he will need to take pill 20 minutes to one hour before sex and the period of time over can very between 3 hours and up to 36 hours.

Others will prefer hormone replacement therapy. Testosterone is the major male hormone that gives men their sexual characteristics. As men age, their level of testosterone decreases and this may have an adverse effect on sexual performance. There also external vacuum devices. This therapy is purported to be effective for over 90% of the men who use it. Often, as a last resort if other treatments have failed, the most common procedure is prosthetic implants which involve the insertion of artificial rods into the penis. A penile prosthesis (implant) is a fixed or mechanical device surgically implanted within the two corpora cavernosa of the penis, allowing erection as often as desired. Most implants are successful. Nowadays there is another option as microsurgery. We talk about penile revascularization and venous ligations which are microsurgical procedures similar in technical complexity to a heart by-pass operation although they clearly do not carry anywhere near the same risk to the life of the patient. Modern medicine offers as well herbal medications. This type of treatment allows men to improve their impotence in future.