Erectile Dysfunction | Neurological or Physical Trauma
Erectile dysfunction (ED Causes Learn More) refers to a type of sexual dysfunction in which the affected male is unable to achieve or maintain erection when sexually stimulated. If left untreated or unaddressed, it may lead to permanent impotency.
Patho-physiologically, erectile dysfunction is broadly classified in physiological and psychological causes. Traumatic causes of erectile dysfunction (ED Help Center Learn More) include both physical injuries and neurological damage to vital machinery that plays an integral role in sexual stimulation.
Besides erectile dysfunction, spinal cord injury or neurological damage can lead to other sexual disorders as well; for example according to a latest research published in Asian Journal of Andrology (1), author suggested that semen samples taken from patients of spinal injuries yield low sperm count (Sperm Mobility Learn More) (with decreased sperm motility as well as vitality) when compared to normal individuals. This is mainly because of higher scrotal temperature as a result of injury/ trauma that also affect testosterone secretion (Hormonal Imbalance Learn More) (ultimately leading to erectile dysfunction)
Primary Traumatic | Neurological Causes of Erectile Dysfunction
The primary causes include
Physical Trauma
– Nerve damage due to bladder cancer (Bladder Cancer Prognosis Learn More) or other injuries of urinary bladder
– Radiation therapy to lower abdominal or pelvic region for the management of malignant conditions
– Certain surgeries such as prostatectomy and cystectomy can also lead to erectile dysfunction due to accidental/ iatrogenic damage to certain nerves that supply pelvic/ inguinal region
– Direct Trauma to the spinal region (or higher up)
– Brain and spinal cord injuries that can also result from traumatic blows or disease processes and may affect nerve impulse conduction to pelvic/ inguinal region.
– Neuro-hormonal diseases such as Parkinson’s and Alzheimer’s disease.
According to a research published in The Journal of Urology (4), scientists identified that 72% patients develop neurogenic erectile dysfunction (of varying degrees) after pelvic fracture and urethral injury. The risk of developing vascular erectile dysfunction is 28%.
Managing Erectile Dysfunction Due to Neurological or Physical Trauma to Pelvic Region
In conditions where the cause of erectile dysfunction (ED Treatment Learn More) is a vascular damage, various interventions can be utilized:
– Shunt implants: These devices allow enhanced blood flow to the pelvic region upon sexual stimulation.
– Pumping devices: Vacuum pumping devices makes use of negative pressure to perfuse the blood supply of copulating organ.
– Ligation surgeries: In these surgeries any blood vessels that may have been damaged due to trauma is sealed off to allow normal erection in response to sexual stimulation due to increased blood flow to penis.
– Rerouting: This is a vessel revascularization technique that is utilized in situations where damage to pelvic region is extensive. The procedure involves maintenance of alternate routes to promote blood flow to inguinal region. The procedure ensures that despite any obstruction or vessel damage, the blood supply to male copulating organ is not compromised.
Non-Surgical Methods
In conditions where the cause of erectile dysfunction is physical, over the counter phosphodiesterase inhibitors can be effectively utilized. Also some surgical implants (Penile Prosthesis Learn More) can result in scarring of tissue that may lead to pain or discomfort after erection or ejaculation. In all such devices, alternative strategies can be employed to restore sexual function. Vacuum devices can also be used as per guided instructions to avoid any organ damage or scarring. Most non-surgical therapies are associated with a high rate of patient satisfaction and are generally considered safe.
References
Momen, M. N., Fahmy, I., Amer, M., Arafa, M., Zohdy, W., & Naser, T. A. (2007). Semen parameters in men with spinal cord injury: changes and aetiology. Asian journal of andrology, 9(5), 684-689.
Giuliano, F., Rubio-Aurioles, E., Kennelly, M., Montorsi, F., Kim, E. D., Finkbeiner, A. E., … & Vardenafil Study Group. (2008). Vardenafil improves ejaculation success rates and self-confidence in men with erectile dysfunction due to spinal cord injury. Spine, 33(7), 709-715.
Fode, M., Krogh-Jespersen, S., Brackett, N. L., Ohl, D. A., Lynne, C. M., & Sønksen, J. (2012). Male sexual dysfunction and infertility associated with neurological disorders. Asian journal of andrology, 14(1).
Shenfeld, O. Z., Kiselgorf, D., Gofrit, O. N., Verstandig, A. G., Landau, E. H., & Pode, D. (2003). The incidence and causes of erectile dysfunction after pelvic fractures associated with posterior urethral disruption. The Journal of urology, 169(6), 2173-2176.
When to Seek Medical Advice for ED?
IF ERECTILE DYSFUNCTION LASTS LONGER THAN 2 MONTHS OR IS A RECURRING PROBLEM, SEE YOUR DOCTOR FOR A PHYSICAL EXAM OR FOR A REFERRAL TO A DOCTOR WHO SPECIALIZES IN ERECTILE PROBLEMS. YOUR OWN DOCTOR OR A SPECIALIST CAN HELP TO DETERMINE THE UNDERLYING CAUSE OR CAUSES OF ERECTILE DYSFUNCTION AND GUIDE YOU TOWARDS FINDING THE RIGHT TYPE OF TREATMENT.
Although you might view erectile dysfunction as a personal or embarrassing problem, it’s important to seek treatment, especially if a physical cause might be developing. In many cases, erectile dysfunction can be successfully treated. Also, see your doctor if the therapy or medication prescribed to treat erectile dysfunction isn’t working for you. Don’t try to combine medications or therapies on your own or deviate from prescribed doses and do not your symptoms as they could be one of Erectile Dysfunction Causes.