Erectile dysfunction diagnosis
Synonyms
Erectile dysfunction, erectile dysfunction, impotence,
medical: Erectile dysfunction (ED)
Diagnosis of erectile dysfunction
There are several steps involved in diagnosing erectile dysfunction. It is usually done by a urologist; he is the responsible specialist.
anamnese: In a conversation, the doctor asks about the patient's symptoms, their severity and their possible dependence on certain situations or factors. In this way it can be clarified whether the erectile dysfunction occurs in relation to the partner, whether it also persists during sleep at night, or whether there are other psychological causes. The urologist also gets an idea of any previous illnesses, operations and risk factors that can lead to erectile dysfunction (diabetes, Vascular diseases, smoking behavior, taking medication, Prostate cancer Etc). This conversation is usually difficult and not pleasant for a man, since erectile dysfunction is a very personal and socially taboo topic. In order to ensure a good diagnosis, however, it is one of the most important building blocks.
Clinical examination: The doctor then examines the patient physically for any visible changes in the penis or the Testicles, whereby injuries or malformations can be detected. Furthermore, he feels the anus wall prostate after enlargements or changes in shape. A test of the so-called can provide information about the proper functioning of the nerve tracts and the important spinal cord segmentsBulbospongiosus reflex (Anal reflex, perineal reflex), as well as the Kremaster reflex (Testicular elevator reflex).
Laboratory diagnostics: They can be used to set certain parameters in the blood which allow a statement to be made about the condition of the blood vessels and the concentration of hormones in the body. In this way, the doctor can narrow down or exclude the various causes of erectile dysfunction. The following values are determined: sober - Blood sugar, Blood lipid levels, Testosterone, SHBG (Steroid hormone binding Globulin).
Specific clinical tests: Depending on the question, various test procedures can then be carried out for a more detailed examination of the erectile tissue and the penile vessels.
The following is an overview of the most important methods
Cavernous pharmacontest (SKAT test): Nowadays it is considered the standard test in the diagnosis of erectile dysfunction. A vasoactive Drug (affecting the vessels) is injected into the side of the erectile tissue with a thin needle. This is usually done Prostaglandin 1 either individually or in conjunction with other vasodilating substances (Papaverine, phentolamine) is used. Due to the anatomically given connection between the three cavernous bodies, the substance distributes itself there by itself.
Doppler sonography: This test is usually combined with the SKAT test. Approx. 10 minutes after the vasoactive substance has been applied to the erectile tissue, an ultrasound probe (see ultrasound) is used to assess the penile arteries responsible for blood filling. The Doppler function on the transducer can represent the pulsating blood flow as a sound, which provides information about the expandability of the vessel width, especially in the first phases of erection.
Read more on the topic: Doppler sonography
Duplex sonography: It is carried out in a similar way to Doppler sonography, only with the additional option of showing the arteries in cross section.
Nocturnal penile tumescence measurement (NPT): This test offers an additional option for recording changes in the frequency and quality of erections at night. 4 - 6 erections with an average duration of approx. 30 minutes per night are considered normal. The measurement is carried out in the sleep laboratory or at home with a device designed for this purpose (e.g. RigiScan). With this method, the suspicion of a mentally caused erectile dysfunction can be substantiated, since the nocturnal erections occur on a purely physical level with the exclusion of consciousness.
