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    A Simple Guide to The Erectile Dysfunction, (Impotence), Diagnosis, Treatment and Related Conditions
    A Simple Guide to The Erectile Dysfunction, (Impotence), Diagnosis, Treatment and Related Conditions
    A Simple Guide to The Erectile Dysfunction, (Impotence), Diagnosis, Treatment and Related Conditions
    Ebook157 pages1 hour

    A Simple Guide to The Erectile Dysfunction, (Impotence), Diagnosis, Treatment and Related Conditions

    By Kenneth Kee

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    About this ebook

    Erectile dysfunction is a disorder in which a man is not capable to get or keep an erection hard enough for sexual intercourse.
    ED is present when a man can:
    1. Get an erection sometimes, though not every time
    2. Get an erection, but it does not harden long enough for sexual intercourse
    3. Not get an erection at any time
    ED is sometimes called impotence.
    Erectile dysfunction is defined by the WHO as "the consistent or recurrent inability of a man to attain and maintain a penile erection of the penis sufficient for sexual performance" for at least 3 months of erectile difficulty.
    Erection occurs:
    Once the brain feels a sexual urge, it passes impulses to local nerves in the penis that produce the muscles of the corpora cavernosa to relax.
    Blood begins to flow in through the arteries and occupies the cavities in the corpora cavernosa like water filling a sponge.
    The perfusing blood increases pressure in the corpora cavernosa, causing the penis expand.
    The membrane tunica albuginea keeps the blood in the corpora cavernosa, thereby maintaining the erection.
    The erection ceases after the man climaxes or after the sexual arousal has ended.
    Then the veins open and the extra blood pass out of the spaces and back into the body.
    Erection problems are frequent in elderly men.
    Emotional causes are more frequent in younger men.
    Physical causes are more frequent in older men.
    Low levels of testosterone can result in erection problems
    1. Vascular disease is the most frequent cause of ED.
    a. Atherosclerosis (hardening of the arteries) is the production of a substance called plaque on the inner lining of arteries
    b. High blood pressure
    c. High cholesterol
    d. Heart disease
    All these conditions affect the blood flowing and out of the penis.
    2. Diabetes: can induce nerve damage and damage to the blood vessel flow to the penis leadng to ED
    3. Nerve disease
    a. Such as spinal cord disease, nerve degeneration from alcohol can decrease the sensitivity of the nerves to the penis
    b. Multiple sclerosis: an autoimmune disease that attacks the nerves
    4. Hormonal problems
    A man’s low levels of testosterone may not cause sufficient stimulation to induce erection
    5. Surgical procedures of rectum, colon or prostate cancer and radiation treatment in the genital area often damage nerves and blood vessels to the penis.
    6. Trauma such as Injury to the penis, spinal cord, prostate, bladder, or pelvis
    Penile nerves function
    1. Nerve testing
    Tests such as the bulbocavernosus reflex test are used to determine if there is sufficient nerve feeling in the penis.
    The doctor presses hard on the glans (head) of the penis which immediately causes the anus to contract if nerve function is normal.
    2. Nocturnal penile tumescence (NPT) to check for normal nighttime erections
    It is normal for a man to have five to six erections during sleep especially during rapid eye movement (REM).
    The absence of erections may indicate a problem with nerve function or blood supply in the penis.
    b. Rigidity monitoring
    There are two methods for measuring changes in penile rigidity and circumference during nocturnal erection: snap gauge and strain gauge.
    Counseling can manage anxiety, stress and marital problems
    There are oral medications available to treat erectile dysfunction e.g. Viagra, Cialis, and Levitra.
    If pills do not work, other treatment methods are:
    a. Apply on cream (Vitaros) for ED
    b. Hormonal Therapy for Erection Problems
    Testosterone, cabergoline, and bromocriptine are hormonal treatments that may help with erectile dysfunction.
    A medicine called prostaglandin E1 injected into the penis or inserted into the urethra improves blood flow to the penis.
    Implanted devices, known as prostheses, can produce an erection in many men with ED.
    TABLE OF CONTENT
    Introduction
    Chapter 1 Erectile

    LanguageEnglish
    PublisherKenneth Kee
    Release dateNov 7, 2016
    ISBN9781370757107
    A Simple Guide to The Erectile Dysfunction, (Impotence), Diagnosis, Treatment and Related Conditions
    Author

    Kenneth Kee

    Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

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      Book preview

      A Simple Guide to The Erectile Dysfunction, (Impotence), Diagnosis, Treatment and Related Conditions - Kenneth Kee

      A

      Simple

      Guide

      To

      Erectile Dysfunction,

      (Impotence)

      Diagnosis,

      Treatment

      And

      Related Conditions

      By

      Dr Kenneth Kee

      M.B.,B.S. (Singapore)

      Ph.D (Healthcare Administration)

      Copyright Kenneth Kee 2016 Smashwords Edition

      Published by Kenneth Kee at Smashwords.com

      Dedication

      This book is dedicated

      To my wife Dorothy

      And my children

      Carolyn, Grace

      And Kelvin

      This book describes the Erectile Dysfunction, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

      (What You Need to Treat Erectile Dysfunction)

      This eBook is licensed for the personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

      If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

      Thank you for respecting the hard work of this author.

      Introduction

      I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Condition) for the benefit of my patients since 2007.

      My purpose in writing these simple guides was for the health education of my patients.

      Health Education was also my dissertation for my Ph.D (Healthcare Administration).

      I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

      This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Conditions into a new Wordpress Blog A Family Doctor’s Tale on http://kenmed.wordpress.com.

      From which many free articles from the blog was taken and put together into 700 amazon kindle books and some into Smashwords.com eBooks.

      Some people have complained that the simple guides are too simple.

      For their information they are made simple in order to educate the patients.

      The later books go into more details of medical conditions.

      The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

      Since 2013, I have tried to improve my spelling and writing.

      As I tried to bring you the latest information about a condition or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

      Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

      I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

      I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

      I apologize if these repetitions are irritating to some readers.

      Chapter 1

      Erectile Dysfunction

      Erectile dysfunction is a rare problem seen in the family clinic in the 1970 -1990.

      Most men do not want to talk about the problem at that time.

      The treatment at that time for one of my patient who has partial transverse paralysis of the lower half of his body was the painful injection of medicine into his penis to harden it before sexual intercourse.

      With the introduction of Viagra and other ED medicine like Cialis and Levitra, men do ask their family doctor about the usage of these medicines and their side effects.

      Since then you will have at least 4 or 5 patients asking for these medicines every month.

      What is Ejaculation Dysfunction (ED)?

      Erectile dysfunction is a medical disorder in which a man is not capable to get or keep an erection hard enough for sexual intercourse.

      ED is present when a man can:

      1. Get an erection sometimes, though not every time

      2. Get an erection, but it does not harden long enough for sexual intercourse

      3. Not get an erection at any time

      ED is sometimes called impotence.

      Erectile dysfunction is defined by the WHO as the consistent or recurrent inability of a man to attain and maintain a penile erection of the penis sufficient for sexual performance

      The WHO sponsored Consultation advises at least 3 months of erectile difficulty to qualify for a diagnosis of Erectile Dysfunction.

      The incidence of ED is unknown:

      1. ED is presently under diagnosed and under treated.

      2. More than 50% of all men 40-70 years old are likely to experience it.

      How does an erection occur?

      The blood flow enters the penis, making it expand and become hard causing an erection.

      The corpora cavernosa consisting of two long chambers inside the penis contain a spongy tissue that sucks the blood into the chambers.

      This spongy tissue has smooth muscles, fibrous tissues, blood-filled spaces, veins, and arteries.

      The membrane encasing the corpora cavernosa is called the tunica albuginea.

      The tube that carries urine and semen outside of the body or urethra passes along the underside of the corpora cavernosa in the middle of a third chamber called the corpus spongiosum.

      A precise sequence of events occurs to induce an erection:

      1. The erection starts with sensory or mental stimulation, or both.

      2. The stimulation may be physical: touch, sound, smell, sight or a sexual image or thought.

      3. Once the brain feels a sexual urge, it passes impulses to local nerves in the penis that produce the muscles of the corpora cavernosa to relax.

      4. Blood begins to flow in through the arteries and occupies the cavities in the corpora cavernosa like water filling a sponge.

      5. The perfusing blood increases pressure in the corpora cavernosa, causing the penis expand.

      6. The membrane tunica albuginea keeps the blood in the corpora cavernosa, thereby maintaining the erection.

      7. The erection ceases after the man climaxes or after the sexual arousal has ended.

      8. The penial muscles contract to cease the inflow of blood.

      9. Then the veins open and the extra blood pass out of the spaces and back into the body.

      What are the causes of erectile dysfunction?

      Erection problems are frequent in adult men.

      Almost all men sometimes have problem getting or maintaining an erection.

      In many patients, this problem resolves by itself with little or no treatment.

      In other patients, it can be an ongoing problem.

      If a man has trouble getting or sustaining an erected penis more than 25% of the time, it is considered a medical disorder.

      As long as the man has continuous problem having an erection his self-esteem is affected and may harm the relationship with the partner.

      Any form of erection problems must be treated.

      Previously, erection problems were believed to be all in the man's mind.

      These men were told not to worry and to relax and the problem will go away.

      Currently doctors believe that physical factors frequently cause erection problems.

      A way to know if the cause is physical is whether the man has night-time erections.

      Normally, men have 3-5 erections every night.

      Each erection lasts for up to 30 minutes.

      The doctor can tell a man how to find out whether he is having the normal number of nighttime erections.

      If the man can have erections in the morning, this will suggest that

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