Erectile Dysfunction Diagnosis

The first step that you should take to be able to diagnose your erectile problem is to visit your GP. It is important that you are able to discuss the problems that you have been suffering from so that you can find out exactly what is causing your condition.

The GP may also ask you some general questions about your lifestyle to try and diagnose your problem. Some examples of these questions are below:
•    What medications or drugs are you currently using? This includes prescription drugs, over-the-counter drugs, herbal supplements, dietary supplements, and illegal drugs or alcohol.
•    Have you had any psychological problems such as stress, anxiety, and depression?
•    When did you first notice symptoms of ED?
•    What are the frequency, quality, and duration of any erection you have had?
•    What are the specifics of the circumstances under which ED first occurred?
•    Do/did you experience erections at night or during the morning?
•    What sexual techniques do you use?
•    Are there problems in your current relationship?
•    Do you have more than one sexual partner?
•    If you have more than one partner, do you experience ED with one or both?
The GP  may also wish to interview your sexual partner since your partner may be able to offer in sight about the underlying causes.

After your exam and interview, your GP may then order any one of the following tests:
•    Physical exam. This may include careful examination of your penis and testicles and checking your nerves for feeling.

•    Blood tests. A sample of your blood may be sent to a lab to check for signs of heart disease, diabetes, low testosterone levels and other health problems.

•    Urine tests (urinalysis). Like blood tests, urine tests are used to look for signs of diabetes and other underlying health conditions.

•    Ultrasound. This test can check blood flow to your penis. It involves using a wand-like device (transducer) held over the blood vessels that supply the penis. It creates a video image to let your GP see if you have blood flow problems. This test is sometimes done in combination with an injection of medications into the penis to determine if blood flow increases normally.

•    Nocturnal penile tumescence (NPT). This test measures a man's erectile function while he is sleeping. Normally, a man will have five or six erections while asleep. A lack of these erections may indicate there is a problem with nerve function or circulation to the penis. The test uses two methods, the snap gauge method and the strain gauge method. The snap gauge method is performed by wrapping three plastic bands of varying strength around the penis. Erectile function is then measured based on which of the three bands breaks. The strain gauge method works by placing elastic bands around the tip and base of the penis. If the penis becomes erect during the night, the bands stretch, measuring the changes in penile circumference.

•    Penile biothesiometry. This test involves the use of electromagnetic vibration to determine sensitivity and nerve function. A decreased sensitivity to these vibrations may indicate nerve damage.

•    Vasoactive injection. During this test, an erection is produced by injecting special solutions that cause the blood vessels to dilate (enlarge), allowing blood to enter the penis.

•    Dynamic infusion cavernosometry. This test is used for men with ED who have a venous leak. During this test, fluid is pumped into the penis at a predetermined rate. By measuring the rate at which fluid must be pumped to attain a rigid erection, GPs can determine the severity of the venous leak.

•    Cavernosography. Used in conjunction with the dynamic infusion cavernosometry, this test involves injecting a dye into the penis. The penis is then X-rayed so that the venous leak can be seen.

•    Arteriography. This test is given to people who are candidates for vascular reconstructive surgery. A dye is injected into the artery believed to be damaged and X-rays are taken.

•    Bulbocavernosus reflex: This test evaluates nerve sensation in the penis. During the test, your GP will squeeze the head of your penis, which should immediately cause your rectum to contract. If nerve function is abnormal, there will be a delay in response time or absence of rectal contraction.

•    PSA: This test may be abnormal due to prostate enlargement or infection, which may complicate ED.

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