Diagnostics

The most important part of ED diagnostics is surely the anamnesis including detailed information on comorbidities or medicines taken by the patient. Therefore, if the problems appear, it is important to pay a visit to a specialist and to fill out a special questionnaire (IIEF-5) which should help in the evaluation of disease severity. Moreover, it is necessary to run blood tests, including the hormonal profile. Apart from a general physical examination, it is also important to carry out a neurological evaluation of scrotal and bulbocavernosus reflexes. An important part, especially in older patients, is the examination of the prostate gland.

These basic examinations should be followed by imaging studies, allowing for a differentiation between psychogenic and organic causes of ED. The main method still remains the Doppler ultrasound examination, which allows for evaluating the condition of the vessels carrying blood to and from the penis, and measuring blood velocity in those vessels. The administration of a vasodilator to cavernous bodies of the penis improves the visualisation of the lesions. Measurements of blood velocity after drug administration allow for an indirect assessment of blood flow disturbances in the vessels, for detection of potential malformations, and for obtaining information on the condition of smooth muscles and on endothelial function.

In case of suspected vascular aetiology, it is recommended to perform computed tomography of abdominal and pelvic blood vessels (so called angio-CT). This specialist examination uses a modern technology and intravenous contrast, for a very detailed image of the status of vessels which deliver  blood to sex organs. This is one of the most precise methods of assessment of erectile dysfunction of arterial origin.

There are also such tests as erectometry and nocturnal penile tumescence. They are based on a simple rule – every man should have at least 3 erections in the night, and his penis should increase its volume by at least 11.5 mm. This is where erectiometer is used, which measures the circumference of the penis.

It is worth mentioning that despite a high importance of psychological factors in ED pathogenesis, most of the patients have an organic disease with overlapping psychological disorders. That is why detailed diagnostics is of key importance in ED treatment.