Ten major causes of organic erectile dysfunction and psychogenic erectile dysfunction: psychological and behavioral therapy
Ten causes of organic erectile dysfunction: (1) Penile anatomical factors: congenital defects (such as intersex, micropenis, ventral penile induration with hypospadias, epispadias or hypospadias), Peyronie's disease, sequelae of penile fracture, fibrosis of the corpora cavernosa (sequelae of penile priapism puncture blood test, sequelae of removal of defective penile prosthesis, idiopathic fibrosis of the corpora cavernosa), thin tunica albuginea of the corpora cavernosa (after removal of penile prosthesis, after resection of columnar aneurysm, idiopathic thin tunica albuginea), loss of penile tissue (secondary to ischemia, infection, injury, after partial or total penectomy), phimosis, lymphoma, dermatitis, cancer and sex reassignment surgery, hydrocele, urethral injury, pelvic fracture. (2) Autoinflammation: severe urethritis, prostatitis, seminal vesiculitis, cystitis combined with psychological disorders, urethral stricture (such as caused by gonorrhea), tuberculosis of the urogenital system, etc. can sometimes also affect erectile function. (3) Postoperative sequelae: perineal prostate biopsy, prostatectomy (simple or radical), abdominoperineal surgery, total cystectomy, aortoiliac artery surgery, external sphincter resection. (4) Congenital vascular abnormalities or obstruction: arteriosclerosis, arteritis, priapism, local vascular thrombosis, embolism, hemangioma, unilateral or bilateral penile artery main branch or branch hypoplasia or abnormal distribution, vascular plexus abnormalities, arteriovenous anastomosis, and abnormalities in the cavernous body blood flow drainage system can all lead to primary erectile dysfunction (accounting for 60% to 70%). It may be related to spontaneous gene mutations that occur during embryonic development. (5) Endurance factors: myocardial infarction, emphysema or pulmonary insufficiency, anemia, systemic diseases (infection, malnutrition), metabolic disorders (kidney and liver failure), sleep disorders, rheumatic fever, elephantiasis. (6) Neurological disorders: Parkinson's disease, temporal lobe lesions or injuries, cerebral palsy, head injury, myasthenia gravis, spinal cord and central nervous system tumors, spinal cord injury with paraplegia (testicular vascular denervation), multiple sclerosis, spinal tuberculosis, spina bifida, subacute combined degeneration, amyotrophic lateral sclerosis with muscle atrophy, sympathectomy, retroperitoneal lymph node dissection, peripheral neuritis. (7) Endocrine or hematological disorders: hyperprolactinemia, obesity-related infertility, craniopharyngioma, acromegaly, diabetes, pituitary adenoma or hypopituitarism, hypothyroidism and adrenal insufficiency, Klinefelter syndrome, hypogonadism, leukemia, pernicious anemia and Hodgkin's disease. (8) Hypertension: arteriosclerosis causing excessive vascular resistance, terminal arteriosclerosis causing decreased perfusion rate, the effect of vasoconstrictors in circulation, histological changes in the corpora cavernosa of the penis, anxiety and fear causing increased blood pressure. (9) Medications: hypnotics, sedatives, phenothiazines, antidepressants, antihypertensive drugs, anti-Parkinson's drugs. (10) Physical factors: erectile dysfunction caused by radiation exposure.
Treatment of psychogenic erectile dysfunction: (1) Confidence method: Patients should have confidence in their sexual ability. As long as they have had successful sexual intercourse, it proves that they are fully capable in this regard. (2) Imagination method: Imagine the pleasant scene when you and your wife are in love and the joyful emotions when you have your first successful sexual intercourse, so that you can easily and happily enter the role. (3) Background diversion method: That is, eliminate factors that are detrimental to the performance of your sexual function. For example, when having sex, separate the children in the same bed or adjust the position of the furniture and bed to avoid the negative effects caused by the scene. (4) Cooperation method: The wife should not complain, blame and doubt her husband's sexual ability after he fails to have sex. Instead, she should be gentle and considerate to her husband. Before having sex, she should actively and passionately caress her husband's skin and say sweet words to create a warm atmosphere of mutual dependence and love, so as to help her husband get rid of the shadow in his heart and restore his masculine spirit. (5) Mind-body regulation method: Change unhealthy lifestyles and attitudes, such as alcoholism, overwork, poor hygiene, irritability, and depression. In the fast-paced modern life, pay attention to regulating your behavior and emotional changes to avoid physical and mental fatigue entering your family life. (6) Drug therapy: Patients with depression can take antidepressants to improve their mood; those with tension can take sedatives in appropriate amounts before sex. (7) Psychotherapy: If patients cannot relieve their mental burden on their own, they should seek psychological treatment from a psychologist. (8) Massage relaxation method: Manual stimulation of certain parts of the body can regulate the function of internal organs. Gentle and mild continuous stimulation can inhibit the central nervous system and excite the peripheral nerves; rapid, heavy, and short stimulation can excite the central nervous system and inhibit the peripheral nerves. Because massage can regulate the human nervous system, it can eliminate mental fatigue.