Diagnosis & Treatment of Erectile Dysfunction

Chronic renal failure is associated with loss of libido and erectile dysfunction. These changes occur by decreasing
testosterone levels, diabetes mellitus, peripheral vascular disorders, medication and neuropathies.

Diagnosis

In any disease, the diagnostic process should be detailed enough to find the correct etiology and to determine the most appropriate treatment. In the case of erectile dysfunction we often not succeed in establishing the exact etiology or an accurate diagnosis, or if achieved, the cause is not reversible, for example, it is possible to reverse diabetic neuropathy.
To establish the diagnosis can be followed several techniques such as arteriography and pressure measurements of the cavernous artery occlusion, with some benefit in selected cases. However, with the advent of effective oral medications,many patients do not want an evaluation, but only receive treatment prescription. In this way the diagnostic process, that once was pretty invasive, can now be tailored to each individual.

Treatment

The physician should inform patients about treatment options, detailing the advantages and disadvantages of each. Should clarify whether the choice it offers is curative or palliative aims to restore permanently the first erection of the patients and includes the correction or suspension of the causal factors. The palliative treatment only give an adequate erection at the time of intercourse, so it should be used whenever the patient has an event of this nature.
After many years of applying invasive treatments, the medical community now has compounds that, while not perfect, are much closer to the ideal treatment than anyone could have imagined just a decade ago.
As mentioned, before 1973 the treatment options for erectile dysfunction were limited, but in the middle of that decade the development of effective penile prosthesis made to increase the number of patients seeking this alternative. In 1982 the accidental discovery of intracavernous injection of papaverine caused the erection created another important therapeutic option; Intracavernous self-injection of vasoactive drugs.
Little progress occurred in the late eighties with the use of vacuum devices, since the mid-nineties, with the approval of intrauterine therapy of alpostadil retral. But the most marked in the history of sexual medicine occurred in 1998 when it was approved sildenafil, the first truly effective oral medication for erectile dysfunction.
Today there is a group of drugs that share the mechanism of action, ie inhibition of phosphodiesterases, such as tadalafil,the var-denafil and the same sildenafil, drugs that cause vasodilation in the corpora cavernosa, which resulting in an erection.
However, there is a percentage of patients who do not respond to these treatment options, either by the severity of vascular damage, or the underlying disease of the disease and in those cases will have to consider the use of vacuum pumps or prostheses, which are rigid, malleable and inflatable.

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