Erectile dysfunction (ED) or impotence is the persistent inability to achieve or maintain an erection. A penile erection is a hydraulic effect of blood entering and being retained in a sponge-like apparatus within the penis. The process is most often initiated as a result of arousal when signals are transmitted from the brain to nerves in the penis.
If erectile dysfunction only occurs occasionally, there is probably nothing to worry about, If it is a frequent occurrence, however, there may be an underlying medical cause. Many men with ED take medications prescribed by a physician such as Viagra and Cialis for many years and achieve unsatisfactory results. Lack of effectiveness associated with ED medications is usually the result of a blood flow problem either into the penis or out of the penis. The most common problem associated with blood flowing into the penis is an arterial blockage.
Causes of Erectile Dysfunction
While ED has many causes, the most important organic cause is an arterial blockage. Arterial blockage or Peripheral Arterial Disease (PAD) is a condition in which blood vessels in the pelvis that supply blood to the penis become narrowed due to atherosclerosis or a buildup of plaque. Atherosclerosis in the blood vessels supplying the penis prevents sufficient blood flow to the penis to sustain an erection. Atherosclerosis of the arteries supplying blood flow to the penis is strongly related to cardiovascular disease that causes arterial blockages in the heart, the blood vessels in the neck, or the blood vessels in the legs. Diabetes has a strong influence on the development of blockages of many arteries in the body including those which supply blood to the penis. Many combinations of medical and lifestyle influences can increase the likelihood of erectile dysfunction. Factors such as smoking, drinking alcohol, obesity, low HDL, and high blood pressure may also contribute to ED.
Diagnosis of Erectile Dysfunction
In our state-of-the-art vascular facility, we perform a thorough and complete vascular diagnostic workup for ED caused by an arterial blockage. In addition to a complete physical and history, we perform highly specialized ultrasound diagnostics to initially investigate the vasculature in the penis. The ultrasound exam is complemented by a highly specialized MRI examination of the blood vessels in the pelvis that is not performed at any other clinic treating ED in California.