Erectile dysfunction discussed with Dr Dhanjee

Erectile dysfunction, or impotence, is a condition which affects thousands of men around the globe. But, thanks to modern medicine and education, it is no longer the taboo subject of yesteryear.

In plain and simple English, impotence is the inability to get or maintain an erection, which leaves one’s sexual life lacking and unsatisfactory for both partners.

Moreover, while erectile dysfunction can be a cause of great distress, it is essential to point out that most men experience occasional issues in obtaining an erection. This, in itself, is nothing to be concerned about, but did you know impotence can be linked to various other medical conditions?

Dr Mahesh Dhanjee, a renowned Specialist Urologist and Robotic Surgeon in Newcastle, highlights, “I have been in the privileged position of serving the urologic needs of the Newcastle community for more than two decades now. Unfortunately, over this time, the most prevalent health-related issues remain unchanged.”

Pointing out that cardiovascular disease remains an important and widely prevalent cause of urologic disease—whereby the doctor states, “Erectile dysfunction is often an early marker for cardiovascular disease, and often predates the onset of cardiac symptoms by 2-3 years. Also, diets high in refined carbohydrates and saturated fats not only increase the risk for cardiovascular disease, but studies have linked such poor dietary habits to an increased risk of developing prostate cancer. Poor dietary habits have also been shown to play a role in the development of kidney stones.”

When touching on the often overlooked point of low testosterone, Dr Dhanjee points out, “Diminished sex drive, erectile dysfunction insomnia, diminished muscle strength, weight gain, lethargy, diabetes, high cholesterol and hypertension could all be related to a low testosterone level. This condition is called hypogonadism. If properly diagnosed, and treated, it not only restores sexual function but often at times improves or corrects the blood pressure, sugar and cholesterol levels too.”

He adds it is essential to remember that not attending to issues such as that of erectile dysfunction could potentially leave underlying cardiovascular risks unchecked, leaving the patient vulnerable to heart attacks and strokes. “Leaving prostate issues unchecked could mean that potentially curable prostate cancer goes untreated, which could cause severe distress or death”.

It is important to stress that erectile dysfunction can be treated at any age. Treatment options include psychotherapy, drug therapy, vacuum pumps and surgery.

But to fully understand erectile dysfunction, one first needs to understand the process involved in obtaining an erection.

An erection begins with sensory and mental stimulation, this depends entirely on your sexual preference. Impulses from the brain then travel down the spinal column and impulses from the nerves in the penis relax smooth muscles in two spongy cylinders that run the length of the penis, parallel to the urethra (the conduit for urine and semen).

Then when the impulses cause the muscles to relax, blood surges into spaces in the spongy tissue, and this pressure results in the penis swelling out. A membrane surrounding the cylinders helps to trap the blood in the penis and maintain the erection. The penis then returns to its flaccid state if the muscles contract, stopping the inflow of blood and opening outflow channels.

Now, an erection problem can occur when any of the events in this sequence are disturbed. While the issue could be psychological, we look at some of the most common physical causes:

  • Damage to arteries, smooth muscles and fibrous tissues.
  • Issues with blood vessels (vascular problems) make up 48% of erection problems.
  • Glitches with the structure of the penis or surrounding tissues cause 3% of erectile dysfunction.

It is necessary to stress that determining the cause of an erectile issue is paramount to addressing the matter—as part of the initial evaluation to determine the possible causes, your doctor may do one of the following:

  • History taking. This involves looking at your sex life, diseases you’ve had, and drugs prescribed to you. This will enable your doctor to review possible risk factors.
  • A complete physical exam (including the abdomen, penis, prostate, rectum, and testicles). If the penis does not respond as expected to certain touch stimuli, there may be a problem with the nervous system.
  • Routine lab tests. This includes blood counts, urine analysis, lipid profile, and measurement of liver enzymes and creatinine. If sexual desire is low, the levels of testosterone in the blood may be measured to determine if there are any endocrine abnormalities.

When visiting your doctor, Dr Dhanjee states that a visit to the urologist should be no different from that of a scheduled visit with any other medical practitioner. To shed further light, the doctor describes how the visit works. “Usually, the patient’s general practitioner, or sometimes the patient himself, makes an appointment with the urologist’s office. Many modern practices have a website which also provides for the possibility of making online bookings. It is important to be relaxed and to feel comfortable in the presence of your urologist. After all, one will be discussing some of life’s most intimate issues with the urologist.”

What changes does Dr Dhanjee advise men make in their lives to improve their prostate, urinary and sexual health?

“The most important lifestyle changes include following a healthy diet, devoid of refined carbohydrates, low in saturated fat, and filled with fresh fruits and vegetables. This, coupled with regular exercise, will ensure not only good general and cardiovascular health, but will also prevent erectile dysfunction, and potentially decrease the risk of prostate cancer. Needless to say, the use of tobacco, recreational drugs and the abuse of alcohol would all contribute to urologic disease and poor sexual health. In fact, cigarette smoking is the leading cause of bladder cancer the world over,” he explains.

With this in mind, be sure to keep a watchful eye over your health and be sure to visit your local urologist if you experience any erectile related issues.

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