VEDI Diagnostics

Erectile Dysfunction diagnostic procedures at VEDI clinic are done comprehensively, during the stay at the clinic. It consists of few basic steps and will be carried out by specialists dealing with various aspects of sexual dysfunction.

The Medical History Interview

Your doctor will take an extensive look at your medical history, including any major health problems that could be associated with erectile dysfunction. You will be asked to answer questions concerning the duration of illness, sexual activity and all psychological or environmental factors. Comorbidities and  all medications you take are also relevant. The medical history interview helps to gather clinical information, point out potential causes and evaluate the severity of the disorder, as well as its impact on quality of life. You will be also asked to fill out medical questionnaires on sexual dysfunction (IIF-15, Mell-Krat’s scale), which complement the medical examination

Physical Examination

After the interview, the doctor will conduct a physical examination to assess the overall condition of your body and look for possible underlying causes of your problem. This examination will be divided into three main parts

General examination and genital examination

It covers general assessment, including measurement of vital parameters, taking blood pressure and pulse (problems with heart rate or BP may indicate the vascular factor as the cause). During the genital examination appearance and function of reproductive organs are evaluated as some features (small testicles, abnormal hair growth) are usually associated with hormonal disturbances, which can be the cause of erectile dysfunction.

• Neurological examination

Short neurological examination includes an assessment of sensation, muscle tone and reflexes. It also tests the main functions of the nerves. Any problems in this regard may suggest the neurological  origin of your problem.

• Digital Rectal Examination

The doctor after appropriate preparation will conduct digital rectal examination. This is a simple and non-invasive procedure involving examination of anus and palpation of rectum. This exam enables the assessment of the prostate and exclusion of its hypertrophy, because any pathologies of prostate may have a major impact on the sexual function.

Laboratory Tests

The next step are blood and urine tests. They will help to detect anomalies in the functioning of various body systems, and diagnose any diseases that could lead to problems achieving erection. Doctor usually orders a variety of blood and urine tests. You will have :

• Full blood count and urinalysis.
• The level of blood sugar and urine (it is necessary to rule out diabetes as it is one of common diseases affecting sexual function)
• Transaminases AsPT, ALT, GGT (high levels of liver enzymes may indicate liver damage, which is associated with impaired hormonal balance and reduced levels of sex hormones)
• Urea, Creatinine (the correct values ​​of these parameters allow to rule out kidney damage, often caused by diabetes) 
• Cholesterol, lipid fractions, triglycerides (these tests are essential, as elevated cholesterol and triglyceride levels usually indicates atherosclerosis, which might also occur in the vessels supplying blood to the penis)

Evaluation of hormones levels in the blood, obviating hormonal imbalance as the cause of sexual dysfunction.

• Total and Free Testosterone
• Prolactin
• Follicle Stimulating Hormonw (FSH), Thyroid Stimulating Hormone (TSH), Luteinic Hormone (LH)
• SHBG (Sex Hormones Binding Globulin )
• Prostate antigen (PSA) - the increased PSA values suggest pathology of prostate.
• Urine test for the presence of sperm culture – any abnormal results of this test may indicate a mechanical failure, congenital defects or urinary tract infections.

Diagnostic imaging

Imaging studies are the final step of the diagnostic process. They enable evaluation of abdominal organs and pelvic blood vessels. Your doctor will perform abdominal ultrasound, and doppler assessment of the vascular system. The blood flow velocity measurement in arteries supplying blood to the penis and the veins draining it from the penis will be evaluated. It allows assessment of flow disturbances in the vessels, their abnormalities, state of smooth muscle and endothelial function.
If your doctor suspects the vascular cause of ED, computed tomography of abdominal blood vessels (called angio-CT) will be performed. In this exam, intravascular administration of contrast dye helps to get a very accurate picture of the vascular system supplying the blood to the genitals. This is one of the best methods used in diagnosing vascular origins of erectile dysfunction.