Diagnosis of Erectile Dysfunction

Of physical or psychic origin, this problem, still taboo, affects millions of men all over the world. If this is your case, you should know that erectile dysfunction has a solution and can be prevented by using Kusuriexpress Valif. Discover how.

The diagnosis of erectile dysfunction consists of two levels and depends on the goals of the patient and his partner, as well as the age, general health and medical condition of the subject. The first level is a detailed medical and psychosexual anamnesis, a complete physical examination, and a hormonal and basic laboratory evaluation followed by a discussion of the therapeutic options without resorting to other studies.

And a second level, which aims to determine precisely the cause of erectile dysfunction, and requires one or more of the following studies: psychological consultation, nocturnal tumescence test (TPN), advanced neurological evaluation and arterial studies and functional venous.

The diagnostic tests of erectile dysfunction are divided into highly recommended, recommended, optional and specialized:

• Highly recommended tests: These must be performed on all patients, and include a complete medical history and a physical examination.
• Recommended tests: They should be performed in most patients, and consist of analytical determinations such as glycemia, lipid profile, free or total testosterone, in people over 50 years, or younger if signs or symptoms of hypogonadism appear, such as decreased sexual desire, bilateral testicular volume, and secondary sexual characteristics.
• Optional tests: They are recommended in certain groups of patients, depending on the medical criteria, and are: blood count, kidney and liver function, hormones (LH, prolactin, TSH, T4 and cortisol in the blood, and urine).
• Specialized tests: they are indicated in those cases in which it is necessary to distinguish between psychogenic and organic nature of the process.

They are the objectification tests of spontaneous erection:

• The registration of nocturnal penile rigidity and tumescence (Rigiscan-NPT): It consists of recording the erections that occur while the patient is asleep. The registration should preferably be made for three nights.
• Test of visual stimulation: It consists of the visualization of erotic films that produce an erection in most men. The presence of an erection rules out that the cause of erectile dysfunction is organic.
• Intracavernous injection test: a substance called prostaglandin E1 is injected along with a visual or auditory stimulus, and the response time is measured. It is useful to differentiate psychogenic from organic dysfunctions.

More specific vascular and neurological studies could also be performed in certain patients:

• Dynamic Doppler ultrasound of the penile arteries: it consists of determining the arterial flow with a prior ultrasound injection of prostaglandin E1 or administration of pro-erection drugs plus visual stimulation.
• Arteriography and cavernosometry: in patients who are going to perform a vascular reconstruction intervention, this test is recommended, which consists of visualizing the thickness of the arteries that infuse the blood into the corpora cavernosa by means of contrast.

According to Kusuriexpress, the objectives of the diagnostic evaluation, whether exhaustive or limited, are:

• Determine the medical and psychological causes.
• Evaluate the severity and degree of responsibility of it.
• Establish a therapeutic strategy that is compatible with the specific diagnosis and meets the expectations of the patient and his partner.