Impotence - nā hiʻohiʻona, nā kumu, nā hōʻike diagnostic no ka maʻi ʻole

He pilikia ka maʻi ʻole no nā kāne he nui. Hiki i nā kumu he nui no ka impotence. Paʻakikī kekahi mau kāne me ka erectile dysfunction a i ʻole ka nele o ke kūkulu ʻana ma muli o ka hoʻohana ʻana i kekahi mau lāʻau lapaʻau. I nā hihia ʻē aʻe, pili ka impotence i nā kumu noʻonoʻo e like me nā maʻi hopohopo, nā traumas i hala, a me kahi paʻakikī penis liʻiliʻi. ʻO ka hana mua i ka ʻike ʻana i ka erectile dysfunction ʻo ka lawe ʻana i kahi mōʻaukala olakino kikoʻī. I ka wā o ka hoʻokolokolo ʻana, hoʻāʻo ke kauka e pane i ka nīnau inā he mea kūlohelohe ka erectile dysfunction (ma muli o kahi maʻi) a i ʻole psychogenic. Ma hope o ka ʻike mua ʻana, ʻōlelo ke kauka i nā ʻanuʻu hou aʻe, ʻo ia paha ka hoʻāʻo ʻana o ka laboratory no ka impotence.

1. Nā hiʻohiʻona a me nā kumu maʻamau o ka impotence

Kuhiule ʻano ʻano kino kane. Pili pinepine kēia pilikia i nā kāne makua, akā ʻaʻole kēia ka lula. Ua pili ka impotence i nā kāne ʻōpio. ʻO ka maʻi ʻole e pili ana i nā pilikia e pili ana: erectile dysfunction o ka penis, hoʻopau piha ʻole, pau ʻole o ke kūkulu ʻana, pilikia kūkulu, nalowale a i ʻole ka emi ʻana o ka naʻau. Loaʻa pinepine ʻia ka maʻi ʻole ma muli o ke kahe koko maikaʻi ʻole. ʻO ke ʻano o kēia kūlana ʻaʻole hiki i ke kanaka ke hoʻokō i kahi kūkulu piha a mau paha.

Auto nā kumu maʻamau o ka impotence:

• psychogenic impotence - hiki ke pili me nā pilikia hopohopo, trauma, liʻiliʻi penis paʻakikī, situational stress, haʻahaʻa haʻahaʻa, homosexuality.
• Hormonal impotence - hiki ke kumu ma muli o ka haʻahaʻa haʻahaʻa o ka testosterone a i ʻole ke kiʻekiʻe o nā pae prolactin i ke kino.
• ʻaʻole hiki ke hoʻokaʻawale ʻia - hiki ke hana ʻia e ka arterial hypertension, atherosclerosis, a i ʻole nā ​​hoʻololi ʻana i nā kīʻaha koko o ka penis.
• Hoʻopili pinepine ʻia ka lāʻau impotence me nā lāʻau koko kiʻekiʻe, antidepressants, a me nā lāʻau i kapa ʻia he antipsychotics.
• neurogenic impotence - loaʻa i nā kāne me nā ʻeha spinal, discopathy, i nā poʻe hilinaʻi i nā mea psychoactive. ʻO nā kumu maʻamau o ka neurogenic impotence kekahi pilikia neurological, hahau, a me ka lolo lolo.

I ka 1/4 o nā kāne, ʻike nā loea i ka mea i kapa ʻia he impotence.

2. Ka hōʻoia o ka impotence

ʻO ka hana mua i ka ʻike ʻana i ka erectile dysfunction ʻo ka lawe ʻana i kahi mōʻaukala olakino kikoʻī. I ka wā e kipa aku ai i ke keʻena, hana ke kauka i ka nānā pono ʻana i ka penis a me nā testicles. Eia kekahi, hana ka loea i kahi ho'āʻo kokoke no ka ʻili o ka ʻili. He mea koʻikoʻi loa ke ana ʻana i ke koko o ke kanaka i loaʻa i ka maʻi ʻole. Pono ke kauka e loiloi i ka hāʻawi ʻana o ke koko i nā ʻaoʻao o ka mea maʻi (pono ka loiloi o ka ʻāʻī a me nā ʻaoʻao haʻahaʻa). I ka wā o ka hoʻokolohua lapaʻau, hana ʻia kahi hoʻokolokolo neurological e loiloi i ke kūlana o ka ʻōnaehana nerve o ka mea maʻi.

ʻO ka loiloi o ka latency o ka bulbocavernosal reflex he mea ʻē aʻe ma ke ʻano dianostic no ka loiloi ʻana i ka reflex bulbocavernosal. I ka wā o ka hoʻokolokolo ʻana, hoʻokomo ka loea i kahi manamana lima lima i loko o ka ʻāʻī a ʻomi iki i ka penis o ka mea maʻi. Ma hope o ke kaomi ʻana i ka penis, pono ʻoe e manaʻo i ka ʻeha o ka rectum me kou manamana lima.

2.1. Hana ʻia nā haʻawina Laboratory i ka ʻike o ka impotence

Hana ʻia nā haʻawina Laboratory i ka ʻike o ka impotence:

• kumu haʻahaʻa hōʻike i ke koko Hiki i ka anemia ke kumu i ka luhi ka hana erectile,
• ka pae o ka glucose i ka serum koko a me ka mimi - e haʻalele i ka maʻi diabetes mellitus,
• ka hoʻoholo ʻana o ka lipid profile - hiki iā ʻoe ke hoʻoholo i ke kiʻekiʻe o ka cholesterol. Hiki i ke kiʻekiʻe kiʻekiʻe ke hōʻike i kahi pilikia o ka atherosclerosis, kahi e ālai ai i ke kahe koko i ka penis.
• ka loiloi hana thyroid (TSH, fT4) - pili nā hormones thyroid i ka hana testosterone. No laila, hiki i ka hemahema o ka hormone thyroid ke hoʻopilikia i ka erectile dysfunction,
• ka loiloi o ka renal (urea, creatinine) a me nā ʻāpana ate (nā enzymes ate, bilirubin), e hiki ai ke loiloi i ka hana o kēia mau kino,
• ka urinalysis maʻamau - i ka hoʻohui ʻana i ka glucose (ka ʻike ʻana i ka maʻi diabetes mellitus) hiki ke hōʻike i ka maʻi maʻi maʻi,
• ʻO PSA kahi antigen i hoʻoholo ʻia i nā maʻi o ka prostate gland.

I nā hihia koʻikoʻi, a i ʻole ka hopena o ka lāʻau i manaʻo ʻia e pili ana i ka ʻike o kēia manawa, hiki ke hana ʻia nā haʻawina ʻoi aku ka paʻakikī e hoʻoholo ai i ke kumu o ka erectile dysfunction.

ʻAʻole hana mau ʻia nā hoʻokolohua endocrinological kūikawā. Hoʻomaʻamaʻa pinepine ʻia lākou i nā kāne, i ka hoʻohui ʻana i ka erectile dysfunction, e nānā i ka emi ʻana a i ʻole ka nalowale o ka libido (sex drive), ka nalowale o nā ʻano moe, e like me ka lauoho kāne. Aia kēia mau mea:

• nā pae testosterone - lawe ʻia ka hormone i ke kakahiaka, i ka wā i kona kiʻekiʻe loa i ke koko,
• prolactin - ʻoi loa i nā kāne ʻōpio me ka nalowale o ka libido. ʻO ke kiʻekiʻe kiʻekiʻe o kēia hormone e hoʻemi i ka nui o ka testosterone i loko o ke koko a, ma o kahi ʻano ʻike ʻole, pili emi libido a me ka erectile dysfunction
• LH/FSH.

3. Ultrasound o ka penis

ʻO ka ultrasound o ka penis kekahi mea hana diagnostic e hiki ai iā ʻoe ke loiloi i ke kūlana olakino o ka mea maʻi. I ka hōʻailona o ka impotence, hoʻohana nā loea Ultrasound o nā aʻa hohonu o ka penis. Hana ʻia kēia hoʻokolohua ma hope o ka hoʻokele intracavernous o nā vasodilators. Hana ʻia ka hoʻāʻo inā kānalua ka vascular erectile dysfunction. ʻO ke kumu o ka hoʻāʻo ʻana, ʻo ia ka hōʻike ʻana i ke kahe koko pololei i loko o nā kīʻaha o ka penis, a inā he hewa, e ʻike inā ua keakea ka pilikia i ke kahe ʻana a i ʻole ke kahe ʻana o ke koko mai ka penis.

ʻO ka hoʻokolohua hou aʻe he ultrasound o nā ʻōpū pelvic a me kahi hoʻokolokolo transrectal. Mahalo i kēia mau mea hana diagnostic, hiki i ke kauka ke hoʻoholo i ke kūlana o nā kino kūloko.

ma ka ʻāpana pelvic. Hiki ke ʻike i ka hypertrophy o ka prostate gland (prostate).

I ka ʻike ʻana o ka impotence, hoʻohana pū nā loea i ka hoʻokolokolo ultrasound o nā testicles a me ka epididymis. Me kēia mau hoʻāʻo, hiki i ke kauka ke hōʻoia a hoʻopau paha i ka hana ʻole o kēia mau kino. He mea koʻikoʻi kēia hoʻāʻo i ka wā e loaʻa ai ka maʻi mai ka hormonal erectile dysfunction (he haʻahaʻa haʻahaʻa kāna testosterone).

4. Nā ʻano hana ʻē aʻe no ka ʻike ʻana i ka impotence

Ma waho aʻe o nā hoʻokolohua laboratory a me nā ultrasound, aia kekahi mau ala ʻē aʻe no ka ʻike ʻana i ka impotence. I kēia manawa, ʻo ke ʻano diagnostic maʻamau i hoʻohana ʻia ʻo ia ka hoʻāʻo ʻana i loko o ke kino cavernous o ka penis. ʻO ka hoʻokele intracavernous

Hoʻokomo ʻia kahi vasodilator i loko o ke kino cavernous (ʻo ka pinepine ʻo alprostadil kahi analogue o prostaglandin). ʻO ka loaʻa ʻana o kahi kūkulu ma hope o ka lawelawe ʻana i ka lāʻau lapaʻau e kāpae i kahi kumu vascular ma ke kumu o ka nele o ke kūkulu ʻana. Hiki ke hoʻohana ʻia ke ala e like me ka post-treatment no ka erectile dysfunction. Makaʻu nā kāne he nui i kēia injection, a me nā pilikia e hiki ke hana i ka wā e hoʻohana ai i kahi injection hoʻāʻo. Hiki i ke ala ke hoʻoulu i ka fibrosis ma ke kahua o ka mea maʻi. Ma waena o nā pilikia ʻē aʻe, ʻōlelo nā kauka i nā puʻupuʻu, nā ʻōpala a me ka curvature o ka penis.

ʻO kekahi ala e ʻike ai i ka impotence ka loiloi ʻana i nā kūkulu pō o ka penis, he hoʻokolokolo hoʻopaʻa ʻole ʻia. Hiki ke hoʻoholo i ka loiloi o ke kūkulu ʻana i ka penile nocturnal inā loaʻa nā pilikia o ke kūkulu ʻana ma muli o nā kumu noʻonoʻo a i ʻole nā ​​mea kūlohelohe. I ka pō o ka hiamoe REM, loaʻa mau 3-5 penile erections. Hōʻike ʻia ka maʻi erectile psychiatric e nā kūkulu pō maʻamau, ʻoiai ʻoi aku ka maʻamau o ka erectile erectile dysfunction.

ʻO ka Arteriography o ka iliac artery i loko he mea ʻē aʻe ma mua o kahi haʻawina invasive imaging, i hana ʻole ʻia, koe wale nō i nā hihia i loaʻa ai ka erectile dysfunction ma muli o ka trauma a i ʻole ka ʻoki mua ʻana ma kēia wahi. Pono ka Artiography i nā poʻe i koho ʻia no ka ʻoki ʻana i nā ʻōpū, e like me ka poʻe ʻōpio ma hope o nā ulia.

ʻO ka Cavernosometry a me ka cavernosography nā hoʻāʻo e ʻae iā ʻoe e hōʻoia i ke kahe koko i loko o nā kino cavernous a ʻike i nā wahi o ka hoʻonui ʻana i ka venous outflow, e kōkua ana i ka erectile dysfunction. ʻO ka hoʻāʻo ʻana e hoʻokomo i ʻelua mau nila liʻiliʻi i loko o ka penis a me ka hoʻokomo ʻana i ka paʻakai, ka lāʻau lapaʻau, a me nā kukui x.

ʻO ke aʻo ʻana o ka vibration sensation kahi ala diagnostic e hiki ai i ka wikiwiki, quantitatively (objectively), outpatient assessment of vibration sensation, ʻo ia kekahi o nā hōʻailona koʻikoʻi o ka sensory neuropathy. Pono ka mea maʻi e hoʻāʻo i ka vibration sensitivity i ke keʻena me ka hoʻomaha a hoʻomaha. Mai puhi ma mua o ka hoʻokolokolo ʻana. Hōʻike nā helu helu ʻo ka puna a me ka hāʻule nā ​​manawa kūpono o ka makahiki e lawe i ka hoʻokolohua. Hoʻohana ʻia ka hoʻāʻo ʻana i ka vibration sensation i nā poʻe i hoʻopilikia ʻia.

nā pilikia o ka naʻau i ka neuropathy diabetic.

5. Testosterone a me ka erectile dysfunction

He mea koʻikoʻi loa nā mea hormonal i ke kūkulu ʻana. Ua manaʻo ʻia ʻo Testosterone he hormone koʻikoʻi no ka hana moekolohe kanaka, akā ʻaʻole maopopo loa kāna kuleana. Ua ʻike ʻia naʻe, ʻo kekahi o nā kumu o ka impotence ʻo ia nā maʻi hormonal i loko o ka ʻōnaehana hypothalamic-pituitary-testicular. ʻO nā maʻi o nā ʻōpū endocrine ʻē aʻe e hoʻopilikia i ka hana o kēia axis endocrine hiki ke loaʻa i kahi hopena maikaʻi ʻole. Eia naʻe, ma kahi o 5% wale nō o nā maʻi e ʻike i ke kauka no ka erectile dysfunction he haʻahaʻa haʻahaʻa testosterone. He nui nā haʻawina e hōʻike ana i ka emi ʻana o nā pae testosterone ke kuleana nui no ka emi ʻana o ka libido, ka ulu ʻana o nā ʻano moe kāne kāne, a me ke kaumaha. No laila, ʻoi aku ka maikaʻi o ka hoʻoholo ʻana i ke kiʻekiʻe o ka testosterone manuahi i nā kāne, me ka impotence, loaʻa nā hōʻailona hou aʻe.

Hana ʻia nā noiʻi Laboratory no ka impotence ma hope o ka hōʻiliʻili ʻana i kahi loiloi piha a me ka hana ʻana i nā hoʻokolohua kūloko. Ma muli o ka ʻikepili i loaʻa, kuhikuhi ke kauka i kekahi mau hoʻokolohua hoʻokolohua. Pono e hoʻomaopopoʻiaʻaʻole he papahana noiʻi maʻamau hoʻokahi, a ua hoʻoholo mauʻia ka hoʻoholo i ke kūlana kūikawā.

Pono ʻoe e kūkākūkā me ke kauka, e-isuance a i ʻole e-prescription? E hele i ka pūnaewele abcZdrowie E ʻimi i ke kauka a hoʻonohonoho koke i kahi hālāwai maʻi maʻi me nā loea mai Polani a i ʻole teleportation.