ERECTILE DYSFUNCTION - DIAGNOSIS & TESTS

Your doctor will ask you questions regarding your ED and about possible risk factors or causes. A physical examination is then performed. You may also be referred to a urologist for further assessment.

Certain tests may be done and these may include:

• Blood tests: to assess for diabetes, high cholesterol, testosterone level, kidney disease etc.

• Urine tests: also to assess for diabetes and kidney disease

• Duplex ultrasound: this ultrasound examination is used to evaluate venous leaks and blood flow into the penis. An injection of prostaglandin is given to induce an erection and and a duplex ultrasound is used to measure blood flow.

• Nocturnal penile tumescence: It is normal for a man to have 5 to 6 erections during sleep. If such erections occur, it means that there is an intact nerve and blood supply to the penis. This nocturnal erections can be measured by a snap or strain gauge.

• Bulbocavernosus reflex test: used to determine if there is an intact nerve system in the penis. When the glands penis is squeezed, there is a normal reflex contraction of the anus.

• Other tests: such as penile biothesiometry, penile angiogram, corpus cavernosometry, magnetic resonance angiography etc are sometimes performed.

ERECTILE DYSFUNCTION - TREATMENT

How ED is treated depends largely on what is causing it. Your doctor will make an assessment of the likely physical and/or psychological components contributing to the problem of ED and decide on the type of treatment most suitable for you.

Treatments (with the exception of testosterone supplementation in those who are testosterone deficient) generally work on a temporary basis, to enable an adequate erection for intercourse, but do not permanently solve the underlying problem.

Oral Medication:

PDE5 Inhibitors: These are prescription drugs which work by blocking the action of PDE5. This results in relaxation of the arteries in the penis when there is sexual stimulation, causing the corpus cavernosum of the penis shaft to fill up with blood. Drugs in this category are: sildenfil (Viagra), tadalafil (Cialis) and vardenafil (Levitra).

Counselling:

Psychological factors causing or contributing to ED need to be managed through counselling.

Injectable drugs, creams and penile suppositories:

These drugs are administered just before intercourse.

Vacuum Therapy:

A penis pump is used to draw blood into the penis. A tension ring is then applied at the base of the penis to maintain the erection by preventing blood from flowing out.

Surgery:

Prosthetic implants are sometimes inserted as a last resort if other treatment modalities have failed.

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