How does Urologist Diagnose Erectile Dysfunction?

Erectile dysfunction is the inability to obtain and maintain an erection sufficient for sexual intercourse. Episodes of temporary erectile dysfunction do not necessarily have to be a reason for concern. But if erectile dysfunction is a constant problem, then a man inevitably has a number of psychological problems: these are problems in the relationship between a man and a woman, low self-esteem, as well as stress and depression.

Most men with erectile dysfunction are afraid of going to the doctor. The main reason is the fear of discussing with another person so intimate problem. However, not all men know that erectile dysfunction is sometimes caused by completely different disorders in the body, which sometimes threaten human life. To such diseases the following health problems refer: a diabetes, an atherosclerosis, illnesses of a liver.

Sexual Anamnesis in the Diagnosis of Erectile Dysfunction

Sexual history can include information about previous and present sexual relationships, the current emotional state, the beginning and duration of erectile dysfunction, and also about previous consultations and treatment. It is necessary to make a detailed description of the rigidity (density, hardness of the penis) and the duration of erection with sexual arousal and spontaneous morning erection, as well as the difficulties associated with sexual arousal, ejaculation and orgasm. Questionnaires for assessing erectile dysfunction, such as the International Index for Erectile Function (IIEF), help to assess all the components of sexual function (erection, orgasm, ejaculation, sexual desire, sexual intercourse and overall satisfaction with sexual relations), and determine the effectiveness of the applied methods of treatment Erectile Dysfunction.

Top-10 Questions You May Be Asked by the Urologist

Due to the fact that there are many causes of impotence, your doctor can use several different tests to diagnose the disorder and prescribe treatment. Effective treatment can be prescribed only after establishing the cause of impotence.

Before sending you for any tests, the doctor must examine your medical record and conduct a thorough medical examination. The doctor can also ask you questions about your personal and sexual life. Some of these questions may seem to you too intimate and even indecent. However, it is important that you answer them honestly. Among such questions there are the following:

  • What medications are you taking right now? This includes prescription drugs, over-the-counter medicines, herbal supplements, dietary supplements (BAA), and illicit drugs or alcohol.
  • Have you suffered from any psychological problems, such as stress, fear or depression?
  • When did you first notice symptoms of impotence?
  • What is the frequency, quality and duration of your erections?
  • Under what circumstances did you first experience impotence?
  • Are you experiencing nocturnal or morning spontaneous erections?
  • What kind of sexual techniques do you use?
  • Are there any problems in your current relationship with a partner?
  • Do you maintain a relationship with several sexual partners?
  • If you have more than one sexual partner, do you experience impotence with both of them?

Methods Used by the Doctor to Diagnose Erectile Dysfunction

Most of the diagnostic tests the doctor can take during the reception and a detailed explanation of the history of the disease. Main methods used to diagnose ED include:

  • Physical examination. This concept includes examination of the penis, testicles, sensitivity testing.
  • General (clinical) blood test:This is a comprehensive blood test, which, among other things, can reveal anemia in a person. Anemia is caused by a low content of red blood cells in the blood and can contribute to an increased fatigue of the body, which in turn causes impotence.
  • Functional tests of the liver and kidney: These blood tests can determine whether impotence is a consequence of impaired liver or kidney function.
  • Blood test for fats: This blood test measures the level of lipids (fats), for example, cholesterol. A high level of lipids may indicate an atherosclerosis (hardening of the arteries), which can disrupt the blood circulation of the penis.
  • Functional Diagnosis of the Thyroid Gland: The function of one of the thyroid hormones is the regulation of the production of sex hormones, the deficiency of which leads to the development of impotence.
  • Blood test for hormones: The level of testosterone and / or prolactin in the blood can be measured in order to detect abnormalities from the normal concentration of any of these hormones.
  • Urinalysis: From the analysis of urine, you can find out a lot of different information, for example, the level of protein, sugar and testosterone. If the content of these substances in the blood differs from the norm, this can be a consequence of diabetes, kidney disease or a low content of testosterone. All this can lead to impotence.
  • Duplex scanning: This test is one of the most effective for detecting impotence. At ultrasonic research high-frequency waves are used for reception of a visual estimation of tissues of an organism. For patients suffering from impotence, duplex scanning can be used to assess the state of the blood flow and identify signs of venous leakage and atherosclerosis, as well as to assess the state of the vascular walls.
  • Bulbocavernous reflex: This test verifies the sensitivity of the nerve endings of the penis. To do this, the doctor will compress the head of your penis, which should lead to contractions of the anal sphincter muscles. If the function of nerve endings is impaired, the response will be slow, or muscle contraction will not occur.
  • Test for the definition of nocturnal erection: This study tests the male erectile function during sleep. Usually during sleep, a man experiences 5-6 episodes of erection. The absence of spontaneous erections may indicate a problem with the nervous function or blood supply of the penis. For this study, two methods are used: the method of measuring the circumference of the penis and the method of measuring its rigidity. For the first method around the penis, three plastic loops of different degree of tension are fixed. Erectile function is determined depending on which of the loops is broken. For the second method, the meter loops are tightened around the circumference of the penis at the root and apex. If an erection happens at night, the loops will taut and the electronic device will record the changes.
  • Biotesiometry of the penis: This test uses electromagnetic vibration to assess the sensitivity of the penis and its innervation.