Erectile Dysfunction: Diagnosis
1. Penile biothesiometry
Penile biothesiometry is another method to gauge the nerve function of the penis. Here, electromagnetic vibration is made use of. A normally functioning penis will be very sensitive to these vibrations. A decreased sensitivity to the electromagnetic vibrations is indicative of the loss of nerve function. Thus, it points towards erectile dysfunction.
2. Bulbocavernosus reflex test
This is a test designed to check and evaluate the penile nerve sensations. The head of the penis is squeezed. In a normal person, this should cause the rectum to contract. A delay in this contraction or its complete absence indicates that there is something wrong with the nerve function. An abnormal nerve function is another indicator of ED.
3. Dynamic infusion cavernosometry and cavernosography
These are tests for those men who have a venous leak. A fluid is pumped into the penis at a fixed, determined rate. Measuring the rate of pumping of fluid necessary to get an erection, the severity of the venous leak can be determined. Cavernosography is another method that is commonly used along with cavernosometry. Here, a dye is also added to the injected fluid. This dye can be detected in X-ray and thus the venous leak can be located and seen. Once this is done, further steps for action can be planned.
4. Analysis of vitals
A battery of tests and check ups can help to determine ED. Checking the values for complete blood count can help to determine anemia. Anemic patients fatigue easily and thus also suffer from ED. Testing the functioning of the liver and kidneys could also help in determining the cause of erectile dysfunction. The lipid profile of a person gives an idea of the cholesterol levels. High levels point to artherosclerosis which affects the blood supply to the penis. Similarly, the thyroid function test helps to determine the cause for ED since the thyroid hormones also regulate the functioning of sex hormones. Finally, the analysis of urine to detect the levels of testosterone, sugar and proteins gives an idea of diabetes, testosterone deficiency and kidney disease, all of which can easily lead to ED.
5. Nocturnal Penile Tumescence
When a man sleeps at night, he usually has about five to six erections. Lack or failure to get these erections may mean problems with blood circulation to the penis or in the nerve function. The test makes use of the snap gauge method and the strain gauge method. In the former, three plastic bands of varying strengths are wrapped around the penis. Based on which of the bands break, the erectile function is measured. In the strain gauge method, plastic and elastic bands are placed around the tip and base of the penis. If and when the penis gets erect at night, the bands expand and stretch, thus measuring the circumference changes in the penile surface.
6. Duplex ultrasound
This is probably the best test to check for ED. The method makes use of sound waves to take ‘photographs’ of the body tissues. Using this ultrasound, the flow of blood can be seen and evaluated. Tissue scarring, artherosclerosis and venous leaks can be easily diagnosed. This test for ED is done in both the erect state as well as the soft state of the penis. The sound waves used are of high frequency.
7. Interview and history
Reviewing the medical history of a patient gives insights into the cause of ED. Thus, taking a detailed interview of the patient helps in the diagnosis. The questions asked may be very intimate and personal in nature. It is very important that the answers be honest and detailed. The sexual partner(s) of the patient may also be interviewed in order to gain more insight. The medications being taken, the relationship quality, circumstances under which ED first happened etc, will all be part of the interview.