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For erectile dysfunction diagnosis you need to consult a doctor usually a urologist who would take a proper medical, personal and sexual history. He would then examine your sexual organs followed by some blood tests and special tests.
The doctor would take a detailed history or would ask you to fill a questionnaire. This would allow him to evaluate the cause of erectile dysfunction. You would be asked some of the following questions:
• If u have a problem in attaining an erection or maintaining it?
• Is it occasional or affects you on regular basis?
• Is it affected by the time, person involved or an emotional stress?
• Is there a reduced desire to have sex?
• How would you rate the the firmness of your penis?
• For how long you have been facing this problem?
• How often you have sex?
• How often you are able to achieve an orgasm or ejaculate?
• How you about your partner or the relationship? Has there been any change in your relationship?
• How often you wake up in the morning with an erection?
• How the general stress level in your life? Has there been increased stress or anxiety?
• Any history of injury, surgery or treatment done in past?
• Any history of alcohol, smoking or drug abuse?
• Any history of medicine intake?
The doctor may also ask your partner some questions regarding your relationship and discuss with her how it may affect your condition.
• Examination of penis: the doctor would look at your penis for any abnormality such as abnormal shape, tight foreskin or abnormal location of the orifice. The shape of the penis is affected in the peyronie’s disease where the penis becomes curved on erection. The tight foreskin may also cause loss of erection.
• The doctor would also touch the penis to check for sensitivity which may be absent in cases of nerve injury.
• Examination of testes: the doctor would check for abnormality of testes such as small testes seen suggestive of testosterone deficiency or abnormally placed testes.
• Examination of the body: to check if you have loss of body hair, breast enlargement or decreased muscle mass which may suggest deficiency of testosterone.
• Examination of cardiovascular system: the doctor would check your blood pressure, hear rate and pulse at wrist and ankle to look for any vascular cause.
Blood tests: are done which check for any underlying cause such as diabetes, atherosclerosis, chronic kidney disease, thyroid disease or low testosterone level. The following test may be done:
• Total testosterone: this is done check for low level of testosterone. You need to get a fasting blood sample done before 10 AM. If a low level of testosterone is found then at least one more time the test is repeated.
• Lipid profile: fasting sample need to be given for total cholesterol, LDL-C, HDL-C, and triglyceride levels.
• Fasting blood glucose or hemoglobin A1C levels to screen for diabetes.
This test is a commonly performed test to check for any abnormality of the blood vessels of the penis. The test is performed by a radiologist before and after an episode of erection. After performing test on flaccid penis the doctor would give you an oral sildenafil tablet or papaverine injection in your penis to help you attain an erection. Once you develop an erection the doctor would do the test now on erected penis. This test checks for both inflow and outflow of blood in the penis.
The test is done to check whether you have a physical or psychological cause for erectile dysfunction. You would be asked to wear a special device or a ring around your penis in the night while sleeping. The test can detect if you get an erection in the night time which is a normal phenomenon in healthy men. Presence of erection suggest a likelihood of psychological or emotional cause. This is test also require in Erectile dysfunction Diagnosis.
If you do not get an erection during the test, you are more likely to have a physical cause.
In this test the doctor would inject a medicine into your penis or put put a medicine in the opening of penis to cause an erection. After this the doctor would check how firm your penis gets and how long does it last.
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