Because most of the patients who are suffering from are ashamed to enlighten their teeth and do not want to go to a regular hospital for treatment; some have taken some aphrodisiacs, and often they are not cured, and money is spent a lot.In fact, impotence is also a common disease. Among the age of men, the prevalence rate is about 10 %, and the incidence rate increases with age.In particular, in the past, more than 90 % of impotence diseases were caused by psychological factors. In the past 10 years, with the continuous progress of the erectile mechanism research, it proves that the quality of impotence is at least 50 % or more.In the future, the instrumental factor is higher.A study at the Tokyo Properties Research Center in 1994 showed that about 19.7 % of the newlywed impotence patients were organized.
The causes of impotence are diverse, mainly divided into two categories: functional and organic.Functional impotence refers to erectile dysfunction caused by psychological factors; organic impotence is divided into neurosterity, vascularity, endocrine, and penile impotence.However, human sexual life is a complex physiological process involving many factors. It is often the interaction of psychological and organic factors and affecting each other. Therefore, it may not cause erection with sound psychological and mild organic lesions.disfunction.
The diagnosis and examination of impotence
There must be a scientific diagnosis and treatment method for patients with or suspected impotence.Generally speaking, when patients come to the doctor, they first collect conventional medical history, physical examination, and routine examinations of hematuria, liver and kidney function and endocrine.At the same time, a simple psychological determination for patients to understand the patient's anxiety, nervousness, anxiety, and depression, which will have a very important guiding role in the use of anxiety and anti -depression drugs in the future.It is also necessary to further do a variety of erectile functions to clarify the specific reasons for impotence.Only after excluding the meticulous etiology can the diagnosis of functional impotence be performed.
There are many ways to check the erectile function. Due to the different technical and equipment of hospitals, the detection methods will be different.The method is:
1. Sexual visual auditory stimulus test (AVSS): Under the sexual and auditory stimulation of sexual visual and auditory stimulation, the penile erection is measured with a penis permeable and hardness instrument (Rigiscan).Hardness is greater than 65 %.
2. Night -erection function measurement: Use brain waves and Rigiscan to record the erection of the penis during the 10 -hour sleep in 10 hours.For more than 15 minutes, one of them increased by 2 & mdash; more than 3 cm during an erection, and the hardness was more than 70 %.
3. Injecting of blood vessel active drugs in the penis sponge: Poppyocyline hydrochloride, prostaglandin E1, phenolitherapy and other drugs in the penis sponge body, and use Rigiscan to record the erectile dynamic value of the penis.
4. Poems and volume measurement of the perfusion of the penis sponge body: This method mainly simulates the congestion process of the penis sponge body. The pumping of the physiological saline is pumped into the penis sponge body.
5. Penis sponge body angiography: Inject blood vessels and contrast agents into the penis sponge body, shoot X -rays of different time phases, observe the filling of the penis sponge body and venous leakage, to determine the surgical path and method.
6. Byuraxin single -optical transmitting electron computer fault scanning penis sponge body hemodynamic measurement: This method is the first in the country, using radioactive nucleo 锝 99 and iodine 131 tabs to dynamically determine the changes in the blood dynamics of the penis sponge body, normalThe value is: the arterial index (PIA) is greater than 60 %, and the venous index (PIV) is greater than -45 %.
7. Application of color ultrasonic: Use color ultrasonic high -frequency probe binding to the use of vascular active drugs in the penis sponge body to determine the changes in the blood flow of the penis.Its normal value is: maximum blood flow rate (PSV) of arterial contraction period (PSV) greater than 25 cm/s, and at the end of diastolic blood flow rate (EDV) less than 5 cm/s, the resistance index (RI) is greater than O.8.
8. Penile sponge sponge muscle stimulation reflection delay test (BCR-L): The normal value is less than 45 milliseconds.
9. Measurement of the one -aeration of the penis (PBL): The normal value is greater than O.75, and this method is rarely used.
Scientific treatment
Once the symptoms of impotence occur, do not vote for medical treatment.Only after a detailed examination can the cause can be found and the cause is treated.At present, the treatment of impotence often uses the following methods:
1. The treatment of sexual psychology in the late 1960s was founded by Master and Johnson, focusing on the guidance and training of sexual behavior methods, that is, based on sexy centralized training and supplemented by biological feedback.In the 1970s, the well -known sexual therapist Caplan combined psychological and behavioral methods to further develop sexual therapy.Several psychological factors affecting erection are common: as follows:
(1) Lack of sexual knowledge: I have not received the necessary sex education during adolescence, do not understand the dissection characteristics of men and women's organs, and often cause psychological trauma in initial sexual intercourse.
(2) Sexual education errors: During the development period, the sexual reactions of parents and religions to children's normal sexual reactions are excessive condemnation, punishment, intimidation, etc., so that sexual activity is a behavior of sin, dirty, inferiority and danger, which causes forced to forceInhibit the normal physical and physiological phenomenon, such as the fear of nocturnal emission and the excessive self -blame for masturbation.
(3) Psychological trauma: The mental trauma of the failure of the first sexual intercourse, fear and anxiety of sexual life, and strong inferiority and guilt such as inferiority and guilt, and the expression of impotence gradually increased.
(4) Uncoordinated relationship: over -worship, fear or resentment, lack of trust, hostile, hatred, etc.There are also lack of patience and cooperation in the women's weakness, indifferent sex, and sexual life.The psychological trauma caused by divorce, widowed puppets, etc. It is difficult to eliminate it. For example, the "husband -in -law syndrome" occurs in men over 50 years of age. During the period of illness or after death, there is no sexual life.Essence
(5) Uncoordinated social relationships: Excessive work and fatigue work, which affects sexual functions and affects sexual functions.
(6) Sexual life occasions are not appropriate: sexual intercourse, poor living conditions, poor psychological stress, fear of pregnancy, fear of sexually transmitted diseases, and fear of peeping.
(7) Medical derived factors: Patients with sexual intercourse failure, doctors can easily diagnose impotence and make them aggravate their ideological burden.The excessive care of family members and loved ones will also increase patients' ideological pressure and it is difficult to recover.
How these psychological factors affect human sexual reactions are currently unclear.Some people think that long -term mental tension, anxiety, and fear may affect the release or activation of the sympathetic nerve of the central nervous nervous adrenal nerve, releasing the norepinephrine to shrink the blood vessels, or changes the endocrine.Studies have found that plasma testosterone levels decreased when the subject is in a tension.
2. The vacuum cable narrowing device uses the principle of vacuum negative pressure attraction to enable the penis to be congested and swelling to the hardness of the energy intercourse.Hardness is sexual intercourse.
3. Drug injection of the drug in the penis sponge injection of hemorrhage active drugs is mainly used for neuropathy and vascular impotence caused by various reasons, and can also be used for psychological impotence patients.The choice of drugs such as Pleeline hydrochloride, phenolitaramine, and prostaglandin EL.The average erection time is O.5 & mdash; 4 hours (average 1.2 hours).
4. Oral drug treatment
(1) Hormone drugs are mainly used for endocrinic erectile dysfunction.More common is the impotence caused by hypothalamus-pituitary-gland axis dysfunctional dysfunction and impotence caused by hypertrophy and high prolactin ledis.
① Hypermiamia is mostly occurred in pituitary tumors, chronic renal failure, and medication (3 ring -ringing and monoamine oxidase inhibitors, methyl Domaba, etc.), hypoglycemia with estrogen, anti -depression, and antimese.Pyntoma can be treated with radiation, surgery and drugs according to the situation.Drug therapy mostly uses dopamine receptor excitement limbolic stops for treatment. The medication should start from a small dose to avoid side effects of the digestive tract.
② Low the function of high -proliferation gonadotropic gonads.Due to tumor, trauma, surgery, mumps and other lesions, testicular injuries are caused, blood testosterone levels are low, and FSH and LH elevated.Exogenous androgen replacement therapy is the most effective.
③ Low aconite hormone gonad functional gonades are low and occurred in hypothalamus and pituitary lesions, which are manifested as blood testosterone, FSH, and LH.The choric membrane to promote gonadotropin (FSH) and luteal hormone release hormone (LHRH) combined application to treat the gonades caused by hypothalamic cerebral lesions, and the effect is more satisfactory.
(2) Non -hormonal drugs are mostly psychological, vascular or neuropathy.
① The most commonly used adrenaline antagonists are phenolitheraming and Yuginbin.
② Pingwei muscle relaxant and nitrite nitrate and nitrite have the effect of loose blood vessel smoothing muscles, thereby expanding the blood vessels.
③ Dopamine receptor agonist dopamine is widely distributed in brain tissue. It is a substance that promotes male animal mating, and dopamine blockers can inhibit their mating behaviors.The subcutaneous injection dopamine receptor blocker Apu Mupine can induce normal people and impotence patients with penile erection.
④ VAIGRA or SildenaFil selectively inhibit the V -type liposserase on the penis sponge body, which relaxes the smooth muscle cells of the penis sponge body, causing the penis sponge body to be rapidly congested and causing erection.The medicine cannot produce effects with low sexual desire or lack of sexual desire, and accidents are prone to occur, so they should be used under the guidance of the physician.
5. Surgical treatment surgery includes arterial concentration of prosthetic implantation, increasing arterial concentration of penile blood supply, and intravenous vein ligation surgery of vein return.With the development of modern diagnostic technology, surgery has opened up a new way for the treatment of impotence.The author uses dual -element single -light sub -transmitting electronic computer fault to scan the blood dynamics measurement technology of the penis sponge body, which improves the diagnosis accuracy of the disease, thereby obtaining the success rate of 80 % of the venous impotence (40 cases).
It is not terrible to suffer from impotence. Clarifying the cause of impotence is the key to the success of impotence.Here, we must warn the majority of patients, do not trust the streets on the street.There are many causes of impotence. Different causes have different therapeutic drugs. It is by no means a drug or a treatment method that can be cured.
(Editor in charge: Internship Liu Suling)
