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Diagnosis of erectile dysfunction

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Erectile dysfunction is the medical terminology used for inability to maintain or complete absence of erection to sustain a sexual intercourse

There could be several causes behind erectile dysfunction and due to this the doctor uses various diagnostic tests to find out the exact reason.

Initial Diagnosis of ED

The initial diagnosis will involve checking the medical and sexual history of the patient accompanied by several laboratory tests. One needs to be mentally prepared to answer the personal questions asked by the doctor very accurately.

Medical history

  • Medicines/supplements/herbs/etc. you have used in past or are using currently.
  • You have any health complication (like high BP, diabetes, kidney, liver or heart disease, cancer, etc.) or undergoing some medical treatment
  • Your sleep pattern or if you have sleeping disorders

Sexual History

Some common questions, the sex expert may ask you are:

  • When and how long you have been experiencing ED
  • Your sexual orientation and relationship with your spouse
  • Your libido and ability to have orgasm and ejaculation
  • Do you have multiple sexual partners?
  • Is stress and work pressure affecting your sexual life?

Physical Exam

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  • It involves examining the penis, the testicles and feeling the nerves.
  • A prostrate examination may also be done to look for an enlarged prostrate which may be interfering with penile blood flow

Laboratory tests

The clinical tests help to determine any underlying health issue that may cause ED. They are

  • Blood test- It is done to determine anaemia, diabetes, sex hormone (testosterone, prolactin) levels, lipid profile, serum creatinine, liver enzymes and liver function, kidney function etc.
  • Urine tests- for analysis of protein, blood sugar as well as testosterone
  • Thyroid function test

Depending on the test reports, your doctor may suggest further advanced tests for detecting other medical condition that might be causing ED.

Advanced Diagnostic Tests for ED

  • Nocturnal Penile Tumescence (NPT) Test- This test is done to monitor nocturnal erections of the concerned individual with the help of an electronic device capable of recording various statistics like the duration, number, circumference of penile erections and rigidity.
  • Duplex ultrasound- The test in performed when the penis is soft and erect, both. It involves taking pictures of the internal tissues to determine blood flow and presence of abnormalities like venous leakage, tissue scarring, calcification, or atherosclerosis.
  • Penile biothesiometry- It’s a neurologic evaluation wherein electromagnetic vibrations are used to determine nerve function and sensitivity of the nerves towards the vibrations. Decreased sensitivity indicates damage in penile nerve or nerves in the pelvic area which could have caused ED
  • Vasoactive injection- A special solution is injected in the penis to cause an erection in order to measure penile pressure. During this process, x ray of the penile blood vessels are also done with the help of a contrast dye
  • Dynamic infusion cavernosometry and cavernosography (DICC )- It measures the blood pressure in the penile arteries and the severity of venous leakage. Cavernosometry involves injecting an erection inducing fluid in the penis and then measuring the rate of infusion needed to get the erection. After that Cavernosography is done to determine the site of venous leakage after injecting a dye in the penis and taking X rays.
  • Bulbocavernosus reflex- It’s a neurologic test done to determine presence of nerve sensatin in the penis. The doctor squeezes the glans (head) of the penis which immediately causes contraction of the anus. If this reflex is delayed or absent, then problems in nerves exist.

The diagnostic tests can let you know the complication that is causing ED in you. Accordingly your doctor will suggest treatment which could be lifestyle changes, simple home remedies or medicines.

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Written by: Saptakee sengupta
Date last updated: January 17, 2015

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