Erectile dysfunction icd 10: How to treat erectile dysfunction

Erectile dysfunction icd 10 : Treatment and solution

erectile dysfunction

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Introduction of Erectile Dysfunction

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Erectile dysfunction is one of the most common male sexual dysfunction in modern world are facing now.

It is the inability to attain or sustain an erection satisfactory for sexual intercourse including sufficient hardship or time.

Most erectile dysfunction is most commonly related to vascular (blood vessels), neurologic(brain or nerves), psychological(thought or mental status), and hormonal disorders(mostly make hormones like testosterone); use of a medication can also be a significant cause.

Evaluation typically includes screening for underlying disorders and measuring testosterone levels in blood.

Treatment options include oral phosphodiesterase inhibitors, intraurethral suppositories, intracavernosal injections, vacuum erection devices, and surgical implants.

These topics will be discussed separately below.

Causes of erectile dysfunction

There are basically two types of erectile dysfunction:

• Primary erectile Dysfunction: a man has never been able to attain or sustain erection
• Secondary erectile dysfunction: a man has previously been able to attain or sustain erection but now he is unable to do so.

Based upon the above types, the causes of ED can be listed as below:

1. Vascular causes/disorders
2. Neurologic causees/disorders
3. Hormonal causes
4. Psychological/Psychiatric causes
5. Systemic illness related causes

Vascular cause of erectile dysfunction:

Out of these, Vascular cause is the most common cause of erectile dysfuntion.

Atherosclerosis, is the major vascular cause to be noted. Other include smoking, endothelial dysfunction, diabetes and autoimmune vasculitis.

Age is the important factor that plays great role side by side on this.

Generally low testosteone level from other hormonal dysorder also causes penile vascular abnormality and hence ED.

Neurological causes of erectile dysfunction include:

1. Stroke
2. Seizures
3. Multiple sclerosis
4. neuropathies
5. spinal cord injuries
1. Diabetic neuropathy
2. Surgical damage of nerves
6. Complication of pelvic surgeries
7. cancer surgeries
8. Cystectomy(removal urinary bladder)
9. TURP (surgery of prostate)

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Hormonal disorders of erectile dysfunction include :

1. primary hypogonadism
2. secondary hypogonadism
3. medicaltion like anti andogens

Other causes of erectile dysfunction:

1. Pelvic radiation
2. Structural disorders of penis like pyronie disease
3. prolonged perineal pressure
4. Perineal trauma
5. sickle cell disease

Medication 

Medication like cocaine use, alcohol, trazodone and inta cavernous injection of multiple injection may also c a use penile tissue destruction and the erectile dysfuncton.

Vasectomy (copyright: mayoclinic)

Can Vasectomy and permanent male sterilization cause erectile dysfunction ?

No, vasectomy cannot cause erectile dysfunction. The explanation is: it blocks the way from which sperms come out by mixing with semen but it doen not reduce serum testosterone level. 

The testosterone that is produced in testicles is released into the blood but not into the semen. Hence this will have no effect on serum testosterone level hence in sexual function as well.

Diagnosis of Erectile Dysfunction

Diagnosis of erectle dysfunction is done clinically. For further confirmation and to rule out other causes further tests cn be done on the basis of clinical judgement.

1. Clinical evaluation
2. Screening for depression and mental illnesse
3. Serum testosterone level

Patient can also be evaluated for the vascular, neurological and systemic illnesses as well.

Sometimes partner sexual dusfunction can also be takie ninto account to rule out the cause related to partner compliance.

Examination is also focused to pelvic, genital and systemic evluation based on history given by the patient.

Patient should be throughly evaluated for hypogonadism and pyronie disease.

Laboratory testing can be done from testosterone level to LH and prolactin as well.

Screening should be done for occult diabetes, dyslipidemia, hyperprolactinemia, thyroid disorders, cushing syndrome as well.

Penile vascular study can be done using vaoactive agents and ultrasound.

Nocturnal penile erection episode can also be measured/monitored to rule out the disgnosis.

Treatment options for Erectile Dysfunctions

Various treatment approaches can be taken to treat erectile dysfunction. the approach can be summarised as below.

1. Treatment of underlying cause
2. Drugs
3. Psychotherapy
4. vaccum devices
5. Self injectable drugs
6. penile prosthesis 

If the patient has any of the following underlying systemic illnesses like diabetes, prolactinsecreting pituitary tumor, hypogonalism, pyronie disease appropriate treatment should be started immediately. Thyroid disease,  dislipidemia, cushing syndrome should also be treated appropriately.

Several vitamins and herbal medicine are claimed to be effective for erectile dysfunction but are not proven yet to be effective.

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The most common drugs used to treat are 5-phosphodiasterase inhibitors like sildenafil, tadalafil etc. These drugs are available over the counter in several countries. These medications are taken orally.

If these treatment are not working, intracavernous or intraurethral prostaglandin E1, vaccum device, surgical implantation or penile prosthesis can be tried and are the final line of the treatment in case of erectile dysfunction.