Post Date April, 15 2023
The incidence of impotence in clinical practice is very high. With the severity of the disease, more and more harm will be done to the patients. We need to understand the pathogenesis of impotence as soon as possible, such as physical weakness, unreasonable diet, and lack of attention to rest, which are very easy to cause impotence. At ordinary times, we should pay attention to the causes of impotence.
1. Neurogenic impotence
Nervous impotence refers to the damage to the erectile center and peripheral nerves of the penis due to various reasons, and the penis can not normally reflex erectile. The erectile function of the penis is controlled by the cerebral cortex, subcortical center and spinal nerve. The spinal cord nerve is located in the lumbosacral spinal cord segment. Brain disease, tumor, cerebrovascular accident, brain injury and brain surgery. Brain lesions can affect the function of thalamus and pituitary. Damage to the function of thalamus and pituitary will cause disorder of hormone secretion, and the secretion of prolactin and sex hormone will affect the erectile function. If the nerve located in the lumbosacral segment is damaged, the nerve fibers that control the penis reflex erection will be injured and impotence will occur.
2. Endocrine fistula
Endocrine impotence refers to sexual dysfunction caused by hormone secretion disorder and regulation imbalance. The regulation of human sex hormones is controlled and fed back by the hypothalamus-pituitary-gonad axis system. The main hormones include thyroxine, epinephrine, sex hormones, prolactin, etc. According to statistics, among all impotence patients, impotence caused by endocrine causes accounts for about 10% - 35%. Clinically, it is mainly divided into primary and secondary.
There are many kinds of endocrine impotence, such as the impotence caused by the damage of parasympathetic nerve innervating perineum caused by diabetes; Abnormal regulation of hypothalamus-pituitary-gonadal axis, decreased androgen release, increased secretion of estrogen and prolactin, resulting in impotence, primary gonadal dysfunction, resulting in a decrease in the level of free testosterone in the blood, resulting in impotence, increased cortisol, which can inhibit the secretion of gonadotropin and testosterone secretion of testicular interstitial cells, resulting in impotence; Feminized tumors can occur in the adrenal gland or testicular interstitial cells, increase estrogen, and atrophy the testicles, leading to impotence; Hyperthyroidism or hypothyroidism may cause impotence due to the production of testosterone and testosterone binding globulin.
3. Functional impotence and organic impotence
Impotence is divided into functional and organic. This is mainly the classification method of impotence, which has very important guiding significance for the identification, diagnosis and treatment of impotence. As the name implies, functional impotence is an erectile dysfunction caused by dysfunction of the mental and nervous system. Generally, the onset is relatively sudden, and there are often psychological stimuli such as fear, depression, anxiety, shock, guilt, and tension. However, the onset of organic impotence is generally relatively slow, often manifested as gradual onset and progressive aggravation, which is mostly related to the organic abnormalities in the physiological anatomy of sexual organs and other visceral organs, or some drug poisoning, trauma, etc.
4. Pituitary fistula
Pituitary impotence is an impotence caused by the complete or partial loss of the function of the anterior pituitary gland, which leads to a decrease in the secretion of all hormones, a decrease in the function of all target glands, and a lack of gonadotropin in men. Pituitary impotence is accompanied by testicular atrophy, degeneration of secondary sexual characteristics, decreased spermatogenesis and infertility. If hypophysis hormone secretion deficiency occurs in children and adolescents, growth and development may be stopped or puberty defects may occur. The human pituitary gland is regulated by the hypothalamus and regulates the activities of the anterior and posterior pituitary lobes through two different ways. Neurohormones synthesized in the hypothalamus regulate the synthesis and secretion of six major peptide hormones in the anterior pituitary, while pituitary hormones regulate the peripheral endocrine glands, such as thyroid, adrenal and gonads. When the function of the anterior pituitary is completely or partially reduced, the symptoms and signs displayed depend on its basic disease and the lack of some specific pituitary hormones.
The vast majority of patients often can't feel anything abnormal, but occasionally they may have a sudden attack or quite intense. Gonadotropin is often the first deficiency, and then growth hormone deficiency. When the thalamus is damaged, the secretion of all hormones decreases, accompanied by hypothyroidism, adrenal insufficiency, hypotension and lack of tolerance to stress and stimulation. Therefore, patients with pituitary impotence are one of the manifestations of hypopituitarism syndrome, not an independent disease. Therefore, the treatment is also comprehensive, and the primary etiological treatment such as pituitary tumor resection is the main treatment. Impotence can be treated only by removing the cause.
5. Vascular fistula
The nutrition and erectile function of the penis depend on the penis arteries and veins. The relaxation of the smooth muscle of the corpus cavernosum makes the opening of the sinus of the penis veins create conditions for the erection of the penis. Any disease that affects the blood flow of penis artery and vein can cause impotence.
The above factors should be recognized as early as possible, and effective treatment should be carried out according to the type of patients. In order to avoid causing more impact, we should pay attention to more rest and comprehensive nursing at ordinary times. At the same time, we should also pay attention to functional exercise in our daily life, so as to avoid causing more pain. We hope that we can not ignore the development of impotence and effectively carry out differential diagnosis.
