Erectile dysfunction
Erectile dysfunction (ED), also known
as impotence, is a type of sexual dysfunction characterized
by the inability to develop or maintain an erection of the penis during sexual
activity. Erectile dysfunction can have psychological consequences as it can be
tied to relationship difficulties and self-image.
The most important organic causes of impotence are cardiovascular
disease and diabetes, neurological problems (for example, trauma
from prostatectomy surgery), hormonal insufficiencies (hypogonadism)
and drug side effects. Psychological impotence is where erection
or penetration fails due to thoughts or feelings (psychological reasons) rather
than physical impossibility; this is somewhat less frequent but can often be
helped. In psychological impotence, there is a strong response to placebo
treatment.
Besides treating the underlying causes such as potassium
deficiency or arsenic contamination of drinking water, the first line treatment
of erectile dysfunction consists of a trial of PDE5 inhibitor (such
as sildenafil). In some cases, treatment can involve prostaglandin tablets
in the urethra, injections into the penis, a penile prosthesis,
a penis pump or vascular reconstructive surgery
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