Diagnosis of Erectile Dysfunction

A thorough physical examination, medical history and various blood tests at the beginning
The diagnosis of erectile dysfunction begins with a thorough physical examination and a thorough exploration of private and professional environment of the individual. Main focus in this occupational injury form and physical damage, such as alcohol and tobacco consumption, medical history and medication taken. A detailed survey is sexual because of psychological factors (private partnership related problems, inhibitions due to different sexual preferences, unfulfilled desire for children) is as important as the determination of hormonal status. The hormone status includes, in particular with decreased libido (sexual desire), the determination of testosterone and prolactin. Also should have their blood fat levels studied, and a daily blood sugar profile can be created.


With ultrasound, the flow properties of blood in the penis assessed
Then the doctor goes on to low-invasive diagnostic methods. The simplest of these is the study of blood flow characteristics in the penis with the Doppler / duplex ultrasound. While the rest of the penile vessels flow values ​​are calculated in not erect state. After administration of a vasoactive agent, ie a drug that draws an involuntary stiffening penis to be located, then the maximum and minimum values ​​measured in the flaccid state. By means of this investigation, a possible vessel-related cause of erectile dysfunction can be detected.


Natural nocturnal penile swelling can be measured
As another low-invasive diagnostic tool is the measurement of nocturnal erections (penile tumescence Nocturne NTP = measurement). Into three consecutive nights, which may occur during different stages of sleep recorded involuntary erections and the duration of erection and penile rigidity (stiffness) can be measured. As standard values ​​3-6 erections per night below are valid at least 10 minute duration and a minimum of 70 per cent rigidity. This study allows a first approach to distinguish between a psychological and organic causes.


Cavernous injection test shows a vascular-related cause of
With the cavernous injection test the doctor with a more simple diagnosis of erectile tissue is available. Here, the erection of the penis after injection behavior of a vasoactive substance is directly assessed in the corpora cavernosa and thus determines the optimal drug at the relevant dose to achieve an erection. Tells the victim throughout the investigation period to a full erection, then most likely caused by a vascular cause or an insufficiency of cavernous muscle cells are excluded.


The infusion is rarely indicated cavernosometry
Or an invasive diagnostic method is penetrating the infusion cavernosometry. Their use is controversial and the guidelines of the German Society of Urology have only indication as to the preparation of operational-reconstructive measures if they are indexed. However, this method is now applied in such a case, only rarely.


With the infusion cavernosometry the pressures within the corpora cavernosa at the erect penis not erect and measured and then a contrast study, the cavernosography, performed to document the penile outflow.