Impotence can be of several types:
Arteriogenic: Where the arteries supplying blood to the penis do not bring in enough blood to cause an erection. There are some patients who are susceptible to narrowing of the arteries, including the elderly, diabetics and people with high blood pressure, although some patients suffering from an injury to the genital area may also suffer from blocked arteries leading to the penis. The latter description is more frequent among younger patients. Injuries that can cause problems may stem from major incidents, such as fracture of the pelvis or pubic bone, or stem from minor injuries, such as bicycle riding that may crease a clot, or thrombus, within the artery leading to the penis. The clot can continue to grow until it completely blocks blood flow going to and from the penis.
Today, it has been established that erectile dysfunction (ED) is a marker, a warning sign, for future cardiovascular diseases like heart attacks and strokes. Diseases of arteries affect the smaller arteries (penis) before they affect the larger ones (coronaries of the heart and carotids of the brain). This should be a strong argument for the benefit of having erectile dysfunction diagnosed and treated early, as medical specialists can then help to detect any early warning signs of other problems developing, such as diabetes, high blood pressure and others.
In a case study, College student S.V.S., 23, became totally impotent following a vehicular accident in which he sustained a fracture of the pelvis and a rupture of the urethra. The patient was hospitalized for almost a month after a surgical operation. Prior to the accident, the patient reported a normal sex life with his fiance. When the patient returned to speak to the doctors who treated the original injurty, he was informed that the problem was likely psychological and that it would be all right in a few months on its own. 12 months later and the patient noticed no improvement at all, forcing him to consider breaking his engagement. It was only after reading a magazine article that prompted him to visit an andrologist. A phalloarteriogram study showed that the main artery to the penis was blocked. The patient was given a microsurgery operation to complete a penile revascularization procedure and was completely cured.
Many men suffer from impotence caused by arteriogenic injuries, but it remains untreated simply because doctors are often unaware of the causative conditions surrounding it. In fact, some of these patients may be wrongfully sent to orthopedic or urology wards for treatment. It's often only after the original wounds or fractures are healed that any impotence problems are discovered. In these cases, the patient learns of the resulting impotence first, and not the doctor.
Venogenic: This is a condition whereby blood leaks from the penis and stops a hard erection forming. In an unaffected male with an erection the veins will shut off blood flow almost totally so that no blood can escape back out of the penis. This allows blood to accumulate in the sinusoids of the penis, thus raising pressure and allowing for the development of rigidity or hardness.
Venogenic erectile dysfunction is very common. It is said to account for as much as 30-70 percent of all impotence. Some men have venogenic impotence from birth (primary). Such men have never had a rigid erection all their lives. Yet there are some men who may develop secondary venogenic impotence suddenly later in life.
Neurogenic: The nerve system leading to the penis is enormously complex. A proper conduction of impulses along these is basic for the initiation and maintenance of an erection. It is these nerves that activate the arteries and the veins and alter the dynamics of blood flow within them.
Many things can go wrong with the nerve supply to the penis. Injuries to the back, especially if they involve the vertebral column and the spinal cord can cause impotence.
There are other nerves that can be affected by other injuries, such as pelvic or perineal trauma. There are a wide range of operations that can cause impotence by causing injury to surrounding nerves of the penis. These include procedures on the rectum, prostate, urethra, spine, retroperitoneum, urinary bladder and others.
There are also some disorders of the nervous system that can affect the nerves to the penis, causing impotence, like multiple sclerosis, myelitis, tumour and others.
Another disease affecting the nerves to the penis is diabetes mellitus. Impotence is a very common complaint among patients with diabetes. It's thought that around 50% of diabetics have impotency problems. However, diabetic impotence is nearly always caused by organic reasons. The treatments diabetics are given won't reverse the actual process of diabetes, so those treatments also won't restore the erectile function. Unfortunately, diabetic treatments tend to only control the blood sugar levels and little else. Modern andrology, however, can offer a cure to nearly all patients with diabetes-related impotence. Once again, this is largely an unknown fact. Very few diabetologists offer their patients a way to treat the resulting erectile dysfunction their diabetes could be causing.
Some drugs are also capable of damaging the nerve endings, which can cause neurogenic impotence. Notable among these are anti-hypertensives (BP lowering) and psychotropics. However, the list is quite extensive. Most doctors will remain completely oblivious to the fact that the drugs being prescribed to treat various ailments could be the culprit for causing impotence as a side effect.
Endocrinologic: Impotence can occur in men who have a hormonal imbalance or otherwise insufficient sex hormones flowing through the blood. It accounts for about 5 to 10 per cent of all organic impotence. Generally, hormonal changes affect the libido (or sex drive) rather than the quality of the erection per se. These hormonal changes may be brought about by a range of diseases.
Mixed: Often, there may be multiple factors that can affect a patient. These patients are often diagnosed with systemic disease. Notable examples are diabetes, kidney failure and liver failure.
Another section of patients with mixed factors for impotence is where the erectile dysfunction itself may lead to other ailments and disorders, such as depression. While the underlying cause of the impotence might be organic, if it's been untreated or undiagnosed it can take a toll on the patient's mind, in most cases because the patient has been told the problem is all within his mind.
Psychogenic: Psychogenic impotence is a diagnosis only made after no organic causes can be identified and the problem really does stem from within the mind. However, prior to giving a patient this particular label, it's important to have an andrologist investigate for any potential organic or bodily causes that could be creating the problem first.
Once this has been done, treatment can commence specifically to treat the problem found.
Arteriogenic: Where the arteries supplying blood to the penis do not bring in enough blood to cause an erection. There are some patients who are susceptible to narrowing of the arteries, including the elderly, diabetics and people with high blood pressure, although some patients suffering from an injury to the genital area may also suffer from blocked arteries leading to the penis. The latter description is more frequent among younger patients. Injuries that can cause problems may stem from major incidents, such as fracture of the pelvis or pubic bone, or stem from minor injuries, such as bicycle riding that may crease a clot, or thrombus, within the artery leading to the penis. The clot can continue to grow until it completely blocks blood flow going to and from the penis.
Today, it has been established that erectile dysfunction (ED) is a marker, a warning sign, for future cardiovascular diseases like heart attacks and strokes. Diseases of arteries affect the smaller arteries (penis) before they affect the larger ones (coronaries of the heart and carotids of the brain). This should be a strong argument for the benefit of having erectile dysfunction diagnosed and treated early, as medical specialists can then help to detect any early warning signs of other problems developing, such as diabetes, high blood pressure and others.
In a case study, College student S.V.S., 23, became totally impotent following a vehicular accident in which he sustained a fracture of the pelvis and a rupture of the urethra. The patient was hospitalized for almost a month after a surgical operation. Prior to the accident, the patient reported a normal sex life with his fiance. When the patient returned to speak to the doctors who treated the original injurty, he was informed that the problem was likely psychological and that it would be all right in a few months on its own. 12 months later and the patient noticed no improvement at all, forcing him to consider breaking his engagement. It was only after reading a magazine article that prompted him to visit an andrologist. A phalloarteriogram study showed that the main artery to the penis was blocked. The patient was given a microsurgery operation to complete a penile revascularization procedure and was completely cured.
Many men suffer from impotence caused by arteriogenic injuries, but it remains untreated simply because doctors are often unaware of the causative conditions surrounding it. In fact, some of these patients may be wrongfully sent to orthopedic or urology wards for treatment. It's often only after the original wounds or fractures are healed that any impotence problems are discovered. In these cases, the patient learns of the resulting impotence first, and not the doctor.
Venogenic: This is a condition whereby blood leaks from the penis and stops a hard erection forming. In an unaffected male with an erection the veins will shut off blood flow almost totally so that no blood can escape back out of the penis. This allows blood to accumulate in the sinusoids of the penis, thus raising pressure and allowing for the development of rigidity or hardness.
Venogenic erectile dysfunction is very common. It is said to account for as much as 30-70 percent of all impotence. Some men have venogenic impotence from birth (primary). Such men have never had a rigid erection all their lives. Yet there are some men who may develop secondary venogenic impotence suddenly later in life.
Neurogenic: The nerve system leading to the penis is enormously complex. A proper conduction of impulses along these is basic for the initiation and maintenance of an erection. It is these nerves that activate the arteries and the veins and alter the dynamics of blood flow within them.
Many things can go wrong with the nerve supply to the penis. Injuries to the back, especially if they involve the vertebral column and the spinal cord can cause impotence.
There are other nerves that can be affected by other injuries, such as pelvic or perineal trauma. There are a wide range of operations that can cause impotence by causing injury to surrounding nerves of the penis. These include procedures on the rectum, prostate, urethra, spine, retroperitoneum, urinary bladder and others.
There are also some disorders of the nervous system that can affect the nerves to the penis, causing impotence, like multiple sclerosis, myelitis, tumour and others.
Another disease affecting the nerves to the penis is diabetes mellitus. Impotence is a very common complaint among patients with diabetes. It's thought that around 50% of diabetics have impotency problems. However, diabetic impotence is nearly always caused by organic reasons. The treatments diabetics are given won't reverse the actual process of diabetes, so those treatments also won't restore the erectile function. Unfortunately, diabetic treatments tend to only control the blood sugar levels and little else. Modern andrology, however, can offer a cure to nearly all patients with diabetes-related impotence. Once again, this is largely an unknown fact. Very few diabetologists offer their patients a way to treat the resulting erectile dysfunction their diabetes could be causing.
Some drugs are also capable of damaging the nerve endings, which can cause neurogenic impotence. Notable among these are anti-hypertensives (BP lowering) and psychotropics. However, the list is quite extensive. Most doctors will remain completely oblivious to the fact that the drugs being prescribed to treat various ailments could be the culprit for causing impotence as a side effect.
Endocrinologic: Impotence can occur in men who have a hormonal imbalance or otherwise insufficient sex hormones flowing through the blood. It accounts for about 5 to 10 per cent of all organic impotence. Generally, hormonal changes affect the libido (or sex drive) rather than the quality of the erection per se. These hormonal changes may be brought about by a range of diseases.
Mixed: Often, there may be multiple factors that can affect a patient. These patients are often diagnosed with systemic disease. Notable examples are diabetes, kidney failure and liver failure.
Another section of patients with mixed factors for impotence is where the erectile dysfunction itself may lead to other ailments and disorders, such as depression. While the underlying cause of the impotence might be organic, if it's been untreated or undiagnosed it can take a toll on the patient's mind, in most cases because the patient has been told the problem is all within his mind.
Psychogenic: Psychogenic impotence is a diagnosis only made after no organic causes can be identified and the problem really does stem from within the mind. However, prior to giving a patient this particular label, it's important to have an andrologist investigate for any potential organic or bodily causes that could be creating the problem first.
Once this has been done, treatment can commence specifically to treat the problem found.
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