The first step in the diagnosis of erectile dysfunction is to historyand physical examination.
Medical questions on medical conditions suffered by the patient,medications taken, or therapies performed surgery, trauma,stressors at work and at home. The patient's psychological stateshould be evaluated, with attention to signs of depression, loss oflibido, insomnia, lethargy, mood swings, etc..
To get information about impotence and to assist physicians inevaluating patients have been created special questionnaires.They are particularly useful, because many men are reluctant to talkabout this issue.
Physical examination is required for each patient and includeblood pressure measurement, and an examination of the genital organs and the prostate - the size of testes, epididymis and vas deferens present, abnormalities of the penis (hypospadias orPeyronie's disease). Physical examination may reveal signs ofprostate cancer, prostate infections, hypertension and testicularatrophy.
Blood tests are intended to determine testosterone levels, and tohighlight some diseases that can cause temporary or permanenterectile dysfunction. For example, blood tests can highlight adiabetes (which can lead to permanent erectile dysfunction) or aninfection (which can lead to temporary erectile dysfunction).
Imaging tests are rarely performed, except pelvic trauma orsurgery. Angiography is useful for patients who are potentialcandidates for surgery. Young men with vascular injury resulting inerectile dysfunction are candidates for this exam. Vascular functionin the penis can be evaluated using a Doppler ultrasound.
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