The erection is a physiological process of both vascular and nervous origin and which is controlled hormonally. It consists of the dilation of the corpora cavernosa.
Erectile dysfunction is called the persistent inability to achieve and maintain an erection that allows adequate sexual satisfaction. Erectile dysfunction despite being an organic disease has many repercussions on quality of life and mental health.
According to the literature that is consulted, the incidence of erectile dysfunction is between 20 and 50% in people over 40 years of age.
Since vascular phenomena are so involved in erection, it is logical that the risk factors for cardiovascular disease are the same as in erectile dysfunction. Sedentary lifestyle, obesity, smoking and hypercholesterolemia.
After open prostatectomies the risk is high.
Causes of Erectile Dysfunction
The main causes of Erectile Dysfunction are:
. Vascular origin:
· Heart disease
· Arterial hypertension
· Mellitus diabetes
. Major surgeries:
· Prostatectomy (total or radical)
· After radiotherapy on the pelvic region
· Parkinson's disease
· Multiple sclerosis
· Brain tumors
· Spinal cord disorders
· Herniated discs
· Peripheral neuropathy due to alcoholism
· Peripheral Diabetes Neuropathy
. Anatomical causes:
· Peyronie's disease.
· Penis fracture
· Congenital curvature of the penis.
· Hypospadias, epispadias.
. Hormonal causes:
· Hyper and hypothyroidism
· Cushing's disease
· Antihypertensives (diuretics and beta-blockers)
· Drugs (heroin, cocaine, methadone)
. Psychological causes:
· Relationship-related problems.
· Lack of sexual stimulation
In erectile dysfunction, the basic principle is to find the cause, identify the risk factors that can be modified, to initiate a preventive and curative intervention.
After correcting modifiable factors or life habits, it is necessary to eliminate easily modifiable causes, such as medications or control of some diseases such as high blood pressure or diabetes. Then it goes to a second phase in which medical treatment begins.
Few causes of erectile dysfunction can be cured with specific treatment. Among them we have:
· Post-traumatic in young patients, after repairing arterial ruptures and improving pelvic blood flow.
· Hormonal due to hypogonadism or hyperprolactinemia, which are completely corrected when the appropriate hormonal treatment is established.
However, most of the causes require general medical treatment, which must be adapted to each particular case. We can differentiate three lines of treatment, which are chosen progressively when the previous line fails.