Page 17 - Echo 2018 Draft zero 5-11-2018 Ready for Print

Erectile Dysfunction

Part 3

article by: Dr. G.M Kiruhi
Consultant Surgeon

o confirm the cause of the • PSA levels: PSA (prostate specific Treatment Options
dysfunction, the doctor may antigen) blood levels and prostate ex- The following are treatments for erec-
Trequest all or some of the amination to exclude prostate cancer tile dysfunction:
following laboratory tests: - is important before starting testoster- . Since many common medications
• Complete blood counts one treatment since testosterone can for treating hypertension, depression,
• Urinalysis: An abnormal urinalysis aggravate prostate cancer. and high blood lipids can contribute
may be a sign of diabetes mellitus • Other blood tests: Evaluation for he- to erectile dysfunction, working with
and kidney damage. mochromatosis, lupus, scleroderma, your doctor to select medications that
• Lipid profile: High levels of LDL cho- zinc deficiency, sickle cell anemia, do not impair erectile function in case
lesterol (bad cholesterol) in the blood cancers (leukemia, colon cancer) are you are on regular medication will
promotes atherosclerosis. some of the other potential tests that improve the condition.
• Blood glucose levels: Abnormally may be performed based on each . Life style modification aimed at
high blood glucose levels may be a individual’s history and symptoms. eliminating modifiable predispos-
sign of diabetes mellitus. ing factors. These include, quitting
• Blood hemoglobin A cw: Abnor- Imaging tests smoking, exercising regularly, losing
mally high levels of blood hemoglobin In a setting of a previous pelvic excess weight, curtailing excessive
A c in patients with diabetes mellitus trauma, X-rays may be performed to alcohol consumption, controlling hy-
establish that there is poor control of assess various bony abnormalities. pertension, and optimizing blood glu-
blood glucose levels. Ultrasound of the penis and testicles cose levels in patients with diabetes.
• Serum creatinine: An abnormal is done occasionally to check for tes- . Taking drugs to treat Erectile Dys-
serum creatinine may be the result of ticular size and structural abnormali- function
kidney damage due to diabetes. ties. Ultrasound with Doppler imaging . Inserting medications into the
• Liver enzymes and liver function can provide additional information urethra
tests: Advanced liver disease (cirrho- about blood flow of the penis. Rarely, 5. Injecting medications into the
sis) can result in hormonal imbalance an angiogram may be performed muscles of the penis
and gonad dysfunction leading to low in cases in which possible vascular 6. Vacuum constrictive devices for
testosterone levels. surgery could be beneficial. the penis
• Total testosterone levels: Blood . Penile prostheses
samples for total testosterone levels Psychosocial examination 8. Psychotherapy techniques are
should be obtained in the early morn- A psychosocial examination using used to decrease anxiety associated
ing (before 8 a.m.) because of wide an interview and questionnaire may with intercourse. The patient’s part-
fluctuations in the testosterone levels reveal psychological factors con- ner can help apply the techniques,
throughout the day. tributing to erectile dysfunction. The which include gradual development
• Other hormone levels: Measure- sexual partner also may be inter- of intimacy and stimulation. Such
ment of other hormones beside tes- viewed to determine expectations techniques also can help relieve
tosterone (luteinizing hormone (LH), and perceptions encountered during anxiety when physical impotence is
prolactin level, and cortisol level) sexual intercourse. being treated. If these simple behav-
may provide clues to other underly- ioral methods at home are ineffective,
ing causes of testosterone deficiency referral to a sex counselor may be
and erectile problems. . advised.

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