Erectile dysfunction
What examinations are performed?
Medical history (anamnesis)
During the consultation with the patient, the doctor will ask you detailed questions about the following:
- Illnesses
- Operations and injuries
- Any medications that you are taking
- Lifestyle factors (stress, smoking, alcohol, other drugs)
- Relative importance of sexuality, sexual behaviour; any attendant changes?
Physical examination
- Assessment of physical build (chest, genitalia, body hair)
- Palpation of the lower abdomen
- Palpation of penis and testicles
- Palpation of prostate (through the rectum).
Laboratory tests
Tests are performed to determine the following and other values:
Red and white blood cell counts, blood fats (triglycerides) and cholesterol (total cholesterol, LDL and HDL), blood sugar, liver values, kidney values, hormone status: total testosterone, SHBG, prolactin, FSH, LH, estradiol and in some cases PSA (in the event of conspicuous findings on the prostate).
Pharmacological test of erectile tissue function
A medication is injected into the penis to expand the blood vessels and trigger an erection to enable ultrasonic measurement (Doppler or duplex sonography) of the blood flow in the erectile tissue. In rare cases of certain blood circulatory disorders, it may also be necessary to perform further examination of the erectile tissue (cavernosometry, cavernosography).
Depending on the results of these tests, other specific tests may also be necessary.
What types of treatment are available?
Thanks to the treatment options that are available today, it is possible to create an individually modified treatment schedule.
In addition to remedying the underlying condition (such as high blood pressure or adjusting the blood sugar), so-called phosphodiesterase inhibitors (e.g. Viagra® Cialis®, Levitra®, and Spedra®) are commonly prescribed nowadays in the form of tablets. Alternatively, a blood vessel-widening medication can be injected into the erectile tissue (auto-injection treatment of erectile tissue) or inserted into the urethra, to effect an erection when desired. These treatment methods enjoy wide acceptance among users.
An alternative form of treatment is a mechanical erection aid in the form of a vacuum pump. In rare cases in which the cause stems from an anomaly of the penile blood vessels, a surgical operation will be required.
If all of the above treatment options fail to provide a suitable solution, it is possible to use a penile tissue implant (penile prosthesis). Two cylinders are implanted in the two erectile tissue sections in the penis. A pressure pump, which is generally placed in the scrotum, pumps a fluid from a reservoir into the cylinders to stiffen the penis. After sexual intercourse, the tissues are emptied through a drainage valve.
If a hormone deficiency has been established, it can be substituted medicinally. You should obtain psychological advice, as even if the cause is an organic one, such a consultation can provide plenty of ideas of how to cope with impotence.
What steps can you take yourself?
If you have a balanced diet, do not smoke and enjoy alcohol in moderation, you are at low risk of becoming impotent. Ensure that any risk diseases such as arteriosclerosis, high blood pressure or diabetes are treated by a specialist at an early stage. As yet, however, no targeted prevention mechanism against impotence is known.
Where can I obtain further information?
If you are having potency problems, you can also contact a sexual advice centre or self-help group, such as
