Erectile Dysfunction

The erection of the penis is a complex process that begins with auditory, tactile, olfactory and visual stimuli and is integrated with the nervous system. Contraction of the structures within the penis causes it to become flaccid, while their relaxation leads to erection. The causes that impair these contracting and relaxing mechanisms present themselves as erectile dysfunction.

Medical Causes of Erectile Dysfunction

• Cardiovascular causes

Since the penis is structurally composed of vessels and vessel-related structures, it is affected by all diseases that affect the cardiovascular system.

• Chronic kidney failure

Erectile dysfunction is seen in more than 50% of patients with chronic kidney failure.

• Diabetes

In diabetes, erectile dysfunction is seen at a high rate regardless of age. Diabetes, which belongs to the group of microvascular diseases, also leads to metabolic syndrome and, by impairing the relaxation function of the vascular structures, causes erectile dysfunction.

• Neurological diseases

Causes of neurogenic origin such as epilepsy, Parkinson's disease, Alzheimer's disease and cerebrovascular diseases lead to erectile dysfunction as a result of the progressive deterioration of certain centers in the central nervous system.

• Hormonal causes

In conditions that restrict or prevent the production and utilization of testosterone, erectile dysfunction is seen in around 10% of cases.

• Other causes

Chronic diseases, other diseases of the penis, medications used for psychogenic conditions and other systemic diseases lead to erectile dysfunction by causing progressive disorders of the urogenital system and degeneration of the microvascular structure.

Surgical Causes of Erectile Dysfunction

Penile erection begins with stimuli at the level of the central nervous system or with a spinal reflex, and is controlled by the sympathetic and parasympathetic nerves. Surgical operations that can disrupt these systems can be examined in 2 groups.

• Direct surgery of the nervous system

• Head trauma/surgery

• Spinal cord trauma/surgery

• Surgeries or traumas that obstruct blood flow to the penis

• Open prostate surgery

• Radical prostatectomy

• Perineal prostatectomy

• Open surgery for bladder tumors

• Bilateral orchiectomy

• And other abdominal surgeries involving the pelvis

Treatment of Erectile Dysfunction

The treatment of this problem is addressed under 2 main headings:

• Non-surgical medical and supportive methods:

• ESWT treatment: shock wave therapy is today a latest-generation treatment method with no complications, short session times, and no need for anesthesia or hospitalization; it treats by renewing and increasing the vascular system of the penis.

• Erection-enhancing medications: at the tissue level, this is a medical treatment that increases vascular permeability for a certain period of time rather than providing a cure.

• Penile injection therapy: this is a quite painful procedure prone to complications, performed by the patient or by medical personnel as an injection into the side of the penis where the superficial blood supply is lowest.

• Surgical methods

The main aim here is to remove the vascular structures inside the penis and replace them with a prosthesis. Infections, tissue incompatibilities and failure of the prosthesis components are the most common side effects.

Effects of Erectile Dysfunction

By nature, the human being is built on 3 main fundamental drives. One of these is sexuality. Erectile dysfunction is a significant condition in men, with psychological as well as physical effects. In fact, it should be addressed not only at the individual level but also at the societal level. Alongside a new-generation treatment such as ESWT for erectile dysfunction, there are also structural changes the individual needs to make. The most important factor is physical activity. To keep the newly formed vessels open and ensure the necessary blood supply, an uninterrupted 45-minute walk each day will both increase the oxygenation of the tissue and ensure its nourishment. In this way, it becomes possible to kill not just two but many more birds with one stone. And by paying attention to nutrition, a healthier and more energetic intimacy can also be achieved.

Erectile Dysfunction and Treatments of Unproven Efficacy

With today's advancing technologies and the growing use of social networks and the internet, we see treatment suggestions for erectile dysfunction from many unqualified people. Such treatment methods not only fail to cure, they deepen the existing problem and make it intractable. Please take the utmost care to ensure that your treatments are always carried out under the supervision of a urologist.