Examinations for erection problems are helpful in determining a specific cause of man’s inability to get or maintain an erection (erectile dysfunction or impotence). Erectile dysfunction is a common problem in men. Most often, erectile dysfunction is caused by a combination of factors such as blood vessel, nerve and psychological factors.
Physical problems that cause erectile dysfunction include:
– Damage to the nerves in the penis. Diseases like multiple sclerosis (chronic inflammatory autoimmune central nervous system) or diabetes (term that designates several distinct diseases that have common metabolic disorder of genetic origin or hormone) can cause nerve damage that affects the ability of men to have an erection. Also, surgery, or radiotherapy various injuries to the pelvis can cause nerve damage
– Problems of blood vessels that provide blood flow to the penis. Diseases like arteriosclerosis (complex pathological process by the destruction of elastic fibers of the arterial walls, replacement of connective collagen fibers, deposition of cholesterol and calcium) that men do have a hard erection. Activities that lead to vasoconstriction of blood to the penis (such as walking long distances by bicycle with his hard and narrow) may increase the risk of developing erectile dysfunction (link)
– Low levels of thyroid hormone or testosterone (hypogonadism)
– The occurrence of adverse effects of medicines required treating depression or hypertension
– Alcohol, smoking or drug use.
If physical problems were excluded, it must be made and psychological tests to see if it is a psychological problem.
– Sexual Performance anxiety
– Couple problems
– The stress
– Depression or distress.
Initial tests in case of impotence include a complete physical examination as well as a detailed history including information about the sexual life of the patient. The physical examination includes measuring blood pressure because high blood pressure and drugs used in its treatment can lead to such problems. The doctor will examine your penis and testicles to detect any changes. They will be recommended by a doctor and a series of blood tests to dispense a number of hormones such as testosterone, luteinizing hormone, prolactin and the thyroid.
It will be done a urine test and a complete blood count, blood sugar (blood glucose dose) and a dose of cholesterol. If the results from these tests are normal doctor will prescribe sildenafil (viagra), tadalafil (Cialis) or vardenafil (Levitra) before proposing other patient exams more expensive.
Other tests that may be performed may include stiffness test and nocturnal erection test or intracavernous injections.
Nocturnal penile tumescence and rigidity testing
This examination can be called stiffness test.
Most men have 3 to 5 erections during deep sleep. Men who can not have an erection due to psychological factors have these erections during deep sleep. Sometimes some sleep disorder or severe depression can lead to lack of erections during the night.
Nocturnal penile rigidity test and determine if the man has normal erections during sleep. This test can be done at home or in a special laboratory.
One can use one of four methods:
– The use of a mechanical device like a ring consisting of two, three thin layers of plastic are placed around the penis. The layers of plastic break certain predetermined pressure
– Using an electronic monitoring device. This method is more expensive, but it is more accurate and gives more detailed information on the number, duration and intensity of erections occurring.
Testing is repeated, usually at least two nights. If an erection occurs during the night means that the main cause of erectile problems is not the physical nature.
Examination by intracavernous injection
During this examination the doctor will inject a drug (usually prostaglandin E1) at the base of the penis to produce an erection. This is called intracavernous injection. A similar drug can be inserted directly into the urethra. This is called intraurethral injection.
After the injection, the following will be measured during erection: penile rigidity and thickness.
These exams are conducted to determine the causes of erectile problems, causes which can be physical, psychological or a combination of both.