To have better timely medical care, making a correct diagnosis should always precede ordering treatment; so is for ED. So, let us get down to properly diagnosing ED.
How can this be done in a right way, and at a right time? Fortunately, reaching an accurate diagnosis is not that hard by following suggestions in How to Handle Sickness.
You will gain much insight on how to observe and collect all pertinent information of ED, including its onset, degree, duration, interval, evolution, resolution, recurrence, etc. And bring those to your doctor for analysis. Then s/he will examine you, and later order the tests that deem necessary.
In short, it is mandatory to have a comprehensive evaluation with detailed history-taking, physical examination, and some needed tests as judged by your doctor.
Detailed history taking – what is it?
This step comprises collecting and reviewing the past and present state of your general health regarding organs/systems as well as a specific detail on how your ED might have changed and evolved over time.
The key points for general health include the level of the existing functional reserve of your brain, heart, lungs, kidneys, and liver. Equally important is personal lifestyle. Afterward, the specific features of your ED will be inquired as that described in How to Handle Sickness, but stressing the sequence of events.
In addition, the expectation of the care for ED has to be discussed and defined. So, tell your doctors straight what you would like to accomplish from the visit. If possible, mindfully stress the understanding and acceptance of Life Reality. Since what we like, want, and love, oftentimes are not what we need.
Because many of us have unknowingly fallen victim to political correctness, distorted commercialism, information over-flooding, and information misunderstanding; so be aware. If you have the above feeling, that is not your fault. In fact, this social phenomenon is a result of intense external social coercion, which is out of your control, but exercise a high level of self-awareness. That is the recommended history taking for good medical care.
What is the expected physical examination? How may the doctor examine you?
After history taking, the doctor will use his professional skills to assess your general mental and physical ability including how your heart and lungs work, and specifically to look at and feel your external genital organs including scrotum (sac), its contents (testes and epididymides), and penis. Usually your doctor will also measure and record the length of the penis and the size of testes.
Besides, the doctor will examine inguinal region to check if you have inguinal hernia. The key point is to assess how your heart and lungs work.
After office visit, the doctor may send you home with a questionnaire called Erectile Dysfunction Inventory of Treatment Survey (EDITS) as a helpful tool to assess your sexual performance.
What kinds of blood tests may be required?
After history-taking and physical examination, your doctor (urologist) will order some blood tests like testosterone, prolactin, gonadotrops, PSA (prostate specific antigen), etc. as needed.
But, remember that not all doctors will order the same tests for the same individual patient. After testing, your doctor will review and discuss the test results with you at return visit. Occasionally, the doctor may call and email you if the report is way out of limit and clinically urgent.
What may be the further testing for ED?
To further confirm what may be the underlying causes for ED, your doctor may do:
1. Nighttime erection test, also called nocturnal penile tumescence monitoring to roughly define if your ED results from organic or psychogenic factors.
2. Testing blood flow to the penis with or without injecting the blood vessel dilating agent and with/without x-ray examination as needed. Testing blood flow in response to vasodilating agent is called cavernosometry; penile x-ray with contrast, cavernosography. These tests are not needed for everyone, but selectively done for younger patients or for someone having prior pelvic/perineal trauma, to whom blood vessel re-connection may be considered.
Note that this information is intended to let you know what to expect. Please do not get nervous; just ask doctor as needed and s/he will help you.
The above information represents the commonly recommended steps of evaluating the patients with erectile dysfunction. The aim is to help you become familiar with ED in order to avoid unnecessary anxiety and fear and to receive the required medical care better and faster from your doctors.
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Of course, if you have further questions, please do not hesitate to reach me at 734-846-2699 or by email to firstname.lastname@example.org. If you need more help/support, set up a private counseling with me to decide what would be most reasonable care for you. Doing so will ease unnecessary anxiety and fear. Don’t you like that? I am ready for you.
James Chin-Ti Lin, M.D.
Certified urologist, award-winning author, and founder of www.ForMeFirst.com and www.sick-ask.com