There are many causes of impotence. Here are some details about diagnosis and treatment.
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Erectile Dysfunction / Impotence
Erectile dysfunction, or impotence, is the inability to erect a sufficient amount of sexual intercourse. Erectile dysfunction should be distinguished from other sexual disorders like libido disorder or disorders of ejaculation.
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As we age, the incidence of erectile problems increases. Around 20-25% of men experience impotence by the time they reach 65. Most cases are caused by side effects of medication, organic disease or blood circulation disorders that reduce blood supply to the penis. Damage to the arteries is the most common cause of impotence. This can be caused by diabetes, nicotine abuse, chronic alcoholism, and other conditions such as arteriosclerosis. These diseases account for 60-70% of cases of impotence.
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Psychological Reasons
Erectile dysfunction can also result from surgical interventions, such as impotence after radical prostatectomy. Impotence can be caused by many medications including blood pressure medication, allergy and depression medication, appetite suppressants and sedatives. In 10-15% of cases, impotence can also be caused by psychological factors such as stress, anxiety and guilt.
Comprehensive Clarification
It is important to determine the root cause of erectile dysfunction before any treatment can be planned or implemented. Clarification includes a detailed anamnesis, which involves asking the patient specific questions, as well as a complete physical examination. It also includes the determination of hormone blood values, and control of liver function and kidney function. Vasoactive substances can be injected into the corpus cavernosum to stimulate erection. Doppler sonographic measurements in the penis blood vessels are helpful before and after the injection.
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Alternative: Surgical Implantation
If all other treatments fail, surgical implantation can be an option. Implantation comes with the usual risks (bleeding, infection and scarring) but there are also potential functional defects that could occur later, which may require repeat surgeries. Swiss health insurance does not cover the costs of such penile prostheses.
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