Ukungabi namandla - izici, izimbangela, izivivinyo zokuxilonga zokungabi namandla

Ukungabi namandla kuyinkinga emadodeni amaningi. Kungaba nezizathu eziningi zokungabi namandla. Amanye amadoda ahlushwa ukungasebenzi kahle kwe-erectile noma ukungaqhanyelwa ngokuphelele ngenxa yokusebenzisa ama-pharmacological agents athile. Kwezinye izimo, ukungabi namandla kuxhunyaniswa nezici ezingokwengqondo ezifana nokuphazamiseka kokukhathazeka, ukuhlukumezeka okwedlule, kanye nenkimbinkimbi yepipi elincane. Isinyathelo sokuqala ekuxilongeni ukungasebenzi kahle kwe-erectile ukuthatha umlando wezokwelapha onemininingwane. Ngesikhathi sokuhlolwa, udokotela uzama ukuphendula umbuzo wokuthi ngabe ukungasebenzi kahle kwe-erectile kuyinto ephilayo (okubangelwa isifo) noma i-psychogenic. Ngemva kokuxilongwa kokuqala, udokotela utusa izinyathelo ezengeziwe, ezingase zihlanganise ukuhlolwa kwelabhorethri ngokungabi namandla.

1. Izimpawu kanye nezimbangela ezivame kakhulu zokungabi namandla

Ukungakwazi umusa ukungasebenzi kahle kocansi kwabesilisa. Le nkinga ngokuvamile ithinta amadoda avuthiwe, kodwa lokhu akuwona umthetho. Kuyenzeka ukuthi ukungabi namandla kuthinta abesilisa abancane. Ukungabi namandla kubhekisela ezinkingeni ezilandelayo: ukungasebenzi kahle kwenduku yomthondo, ukungami kahle, ukungaqhanyelwa ngokuphelele, izinkinga zokuqhanyelwa, ukulahlekelwa noma ukuncipha kokuzwela ngokobulili. Ukungabi namandla ngokuvamile kwenzeka ngenxa yokungahambi kahle kwegazi. Lesi simo sisho ukuthi owesilisa akakwazi ukufeza ukumiswa okuphelele noma okuhlala njalo.

auto izimbangela ezivame kakhulu zokungabi namandla:

• ukungabi namandla kwengqondo - kungase kuhlotshaniswe nokuphazamiseka kokukhathazeka, ukuhlukumezeka, inkimbinkimbi yepipi elincane, ukucindezeleka kwesimo, ukuzethemba okuphansi, ubungqingili.
• Ukuphelelwa amandla kweHormonal - kungabangelwa amazinga aphansi e-testosterone noma amazinga aphezulu e-prolactin emzimbeni.
• ukungakwazi ukujikeleza kwegazi - kungabangelwa umfutho wegazi ophakeme, isifo sokuqina kwemithambo yegazi, noma izinguquko emithanjeni yegazi yomthondo.
• Ukungabi namandla kwezidakamizwa kuvame ukuhlotshaniswa nemithi yomfutho wegazi ophakeme, ama-antidepressants, nezidakamizwa ezaziwa ngokuthi ama-antipsychotics.
• ukungabi namandla kwe-neurogenic - kwenzeka emadodeni anokulimala komgogodla, i-discopathy, kubantu abancike ezintweni ezithinta ingqondo. Izimbangela ezivamile zokungabi namandla kwe-neurogenic nazo ziyizinkinga zemizwa, imivimbo, noma izimila zobuchopho.

Ku-1/4 yamadoda, ochwepheshe baxilonga lokho okubizwa ngokuthi ukungabi namandla okuxubile.

2. Ukuxilongwa kokuphelelwa amandla

Isinyathelo sokuqala ekuxilongeni ukungasebenzi kahle kwe-erectile ukuthatha umlando wezokwelapha onemininingwane. Ngesikhathi evakashele ehhovisi udokotela uhlola umthondo namasende. Ngaphezu kwalokho, uchwepheshe wenza ukuhlolwa okulinganiselwe kokuzwela kwesikhumba. Kubaluleke kakhulu ukukala umfutho wegazi womuntu onenkinga yokungabi namandla. Udokotela kufanele futhi ahlole ukunikezwa kwegazi emaphethelweni esiguli (ukuhlolwa kwe-groin nemikhawulo ephansi kufanelekile). Ngesikhathi sokuhlolwa komtholampilo, ukuhlolwa kwe-neurological nakho kwenziwa ukuze kuhlolwe isimo sesimiso sezinzwa zesiguli.

Ukuhlolwa kokubambezeleka kwe-bulbocavernosal reflex akuyona into engaphezu kwendlela ye-dianostic yokuhlola i-bulbocavernosal reflex. Ngesikhathi sokuhlolwa, uchwepheshe ufaka umunwe oyiglavu embotsheni ye-rectum futhi awukhame kancane umthondo wesiguli. Ngemuva kokucindezela ipipi, kufanele uzwe ukushuba kwe-rectum ngomunwe wakho.

2.1. Izifundo zaselabhorethri ezenziwa ekuxilongweni kokuphelelwa amandla

Izifundo zaselabhorethri ezenziwa ekuxilongweni kokuphelelwa amandla:

• aphansi ukuhlolwa kwegazi I-anemia nayo ingabangela ukukhathala ukungasebenzi kahle kwe-erectile,
• amazinga e-glucose ku-serum yegazi nomchamo - ukukhipha isifo sikashukela i-mellitus,
• Ukunqunywa kwephrofayili ye-lipid - kukuvumela ukuthi unqume izinga le-cholesterol. Izinga eliphakeme lingase libonise ingozi ye-atherosclerosis, evimbela ukuhlinzekwa kwegazi epipini.
• ukuhlolwa komsebenzi wegilo (TSH, fT4) - amahomoni egilo athinta ukukhiqizwa testosterone. Ngakho-ke, ukuntuleka kwe-hormone yegilo kungathinta ukungasebenzi kahle kwe-erectile,
• ukuhlolwa kwezinso (urea, creatinine) kanye nemingcele yesibindi (ama-enzyme esibindi, i-bilirubin), okuzovumela ukuhlola umsebenzi walezi zitho,
• urinalysis jikelele - ngaphezu kokuba khona kweglucose (ukutholwa kwesifo sikashukela i-mellitus) kungabonisa isifo sezinso,
• I-PSA iyi-antigen enqunywa ezifweni ze-prostate gland.

Ezimweni eziyinkimbinkimbi kakhulu, noma lapho ukwelashwa okuphakanyisiwe okusekelwe ekuxilongweni kwamanje kungasebenzi, izifundo ezengeziwe eziyinkimbinkimbi zingenziwa ukuze kutholakale imbangela yokungasebenzi kahle kwe-erectile.

Ukuhlolwa okukhethekile kwe-endocrinological akwenziwa njalo. Ngokuvamile batuswa emadodeni okuthi, ngaphezu kokungasebenzi kahle kwe-erectile, aqaphele ukwehla noma ukulahlekelwa i-libido (i-sex drive), ukulahlekelwa izici zocansi, njengezinwele zesilisa. Lokhu kubandakanya:

• amazinga e-testosterone - i-hormone ithathwa ekuseni, lapho isezingeni eliphezulu kakhulu egazini,
• i-prolactin - ikakhulukazi emadodeni amancane alahlekelwa i-libido. Izinga eliphezulu laleli hormone linciphisa inani le-testosterone egazini futhi, ngokusebenzisa indlela engaziwa, ithinta yehlisa i-libido kanye nokungasebenzi kahle kwe-erectile
• I-LH/FSH.

3. I-Ultrasound yomthondo

I-Ultrasound yomthondo kungenye ithuluzi lokuxilonga elikuvumela ukuthi uhlole isimo sempilo yesiguli. Ekuxilongweni kokuphelelwa amandla, ochwepheshe basebenzisa I-Ultrasound yemithambo ejulile yomthondo. Lokhu kuhlolwa kwenziwa ngemuva kokuphathwa kwe-intracavernous yama-vasodilators. Ukuhlolwa kwenziwa uma kusolwa ukungasebenzi kahle kwe-vascular erectile. Inhloso yokuhlolwa ukukhombisa ukugeleza kwegazi okulungile ezitsheni zepipi, futhi uma kwenzeka ukwephulwa, ukuxilonga ukuthi inkinga ivinjiwe yini ukungena noma ukuphuma kwegazi epipini.

Ukuhlolwa okulandelayo yi-ultrasound yezitho ze-pelvic kanye nokuhlolwa kwe-transrectal. Ngenxa yala mathuluzi okuxilonga, udokotela angakwazi ukunquma isimo sezitho zendawo.

endaweni ye-pelvic. Kungenzeka futhi ukukhomba i-hypertrophy engaba khona ye-prostate gland (prostate).

Ekuxilongweni kokuphelelwa amandla, ochwepheshe basebenzisa nokuhlolwa kwe-ultrasound kwamasende kanye ne-epididymis. Ngalokhu kuhlolwa, udokotela angaqinisekisa noma akhiphe ukungasebenzi kwalezi zitho. Lokhu kuhlolwa kubaluleke kakhulu lapho isiguli sinenkinga yokungasebenzi kahle kwe-hormonal erectile (sinamazinga aphansi e-testosterone).

4. Ezinye izindlela zokuxilonga ukungabi namandla

Ngaphezu kokuhlolwa kwaselabhorethri kanye ne-ultrasound, kunezinye izindlela zokuxilonga ukungabi namandla. Njengamanje, indlela yokuxilonga evame ukusetshenziswa umjovo wokuhlola emzimbeni we-cavernous wepipi. Umjovo we-Intracavernous

i-vasodilator ijova emzimbeni we-cavernous (imvamisa i-alprostadil iyi-analogue ye-prostaglandin). Ukuthola i-erection ngemuva kokuphathwa komuthi akufaki imbangela ye-vascular njengembangela yokuntuleka kokumiswa. Indlela ingasetshenziswa futhi njengokwelashwa kwangemuva kokungasebenzi kahle kwe-erectile. Amadoda amaningi ayawesaba lo mjovo, kanye nezinkinga ezingase zibe khona uma usebenzisa umjovo wokulinga. Indlela ingabangela i-fibrosis endaweni yomjovo wesiguli. Phakathi kwezinye izinkinga, odokotela bakhuluma ngamaqhubu, imihuzuko nokugobeka komthondo.

Enye indlela yokubona ukungabi namandla ukuhlolwa kokumiswa komthondo ebusuku, okuwukuhlolwa okungahleliwe. Ukuhlolwa kokumiswa komthondo wasebusuku kunganquma ukuthi izinkinga zokuqhanyelwa zibangelwa izici ezingokwengqondo noma zezinto eziphilayo. Phakathi nobusuku bokulala kwe-REM, kuvamise ukuba nama-penile erection angu-3-5. I-Psychiatric Erectile Dysfunction ibonakala ngokumiswa okujwayelekile kwasebusuku, kuyilapho ukungasebenzi kahle kwe-organic erectile kungavamile noma akukho.

I-Arteriography yomthambo wangaphakathi we-iliac akuyona into engaphezu kwesifundo se-imaging esihlaselayo, esingavamile ukwenziwa, ngaphandle kwalapho ukungasebenzi kahle kwe-erectile kubangelwa ukuhlukumezeka noma ukuhlinzwa kwangaphambilini kule ndawo. I-Arteriography iwusizo kubantu abangase bakwazi ukuhlinzwa imithambo yegazi, njengabantu abasha ngemva kwezingozi.

I-Cavernosometry kanye ne-cavernosography ukuhlolwa okukuvumela ukuthi uqinisekise umfutho wegazi ngaphakathi kwemizimba ye-cavernous futhi uhlonze izindawo zokuphuma kwe-venous okwenyuka, okunomthelela ekungasebenzi kahle kwe-erectile. Ukuhlolwa kuhilela ukufaka izinaliti ezimbili ezincane epipini nokujova usawoti, umuthi wokuqhanyelwa, kanye nama-x-ray.

Ukuhlolwa kokuzwa kokudlidliza kuyindlela yokuxilonga evumela ukuthi kusheshe, ngokwenani (ngokuqondile), ukuhlolwa kwesiguli esingaphandle kokuzwa kokudlidliza, okungenye yezinkomba ezibucayi kakhulu ze-sensory neuropathy. Isiguli esizohlolwa ukuzwela ukudlidliza kufanele sifike ehhovisi siphumule futhi siqabulekile. Ungabhemi ngaphambi kokuhlolwa. Izibalo zibonisa ukuthi intwasahlobo nekwindla yizikhathi ezikahle kakhulu zonyaka zokuhlola. Ukuhlolwa kokuzwa kokudlidliza kusetshenziswa kubantu abathintekile.

ukuphazamiseka kwezinzwa ku-diabetesic neuropathy.

5. I-Testosterone kanye nokungasebenzi kahle kwe-erectile

Izici ze-Hormonal zidlala indima ebaluleke kakhulu ekuqhameni. I-Testosterone ibhekwa njengehomoni ebalulekile emsebenzini wocansi womuntu, kodwa indima yayo ayikachazwa ngokugcwele. Nokho, kuyaziwa ukuthi enye yezimbangela zokuphelelwa amandla wukuphazamiseka kwamahomoni ohlelweni lwe-hypothalamic-pituitary-testicular. Izifo zezinye izindlala ze-endocrine eziphazamisa umsebenzi wale eksisi ye-endocrine nazo zingaba nomthelela omubi. Kodwa-ke, cishe i-5% yeziguli ezibona udokotela ngenxa yokungasebenzi kahle kwe-erectile ezinamazinga aphansi e-testosterone. Ucwaningo oluningi lukhombisa ukuthi ukwehla kwamazinga e-testosterone yikhona okuyimbangela yokuncipha kwe-libido, ukukhula okungavamile kwezici zobulili zabesilisa, nokudangala. Ngakho-ke, ukunquma izinga le-testosterone yamahhala kunconywa ikakhulukazi emadodeni okuthi, ngaphezu kokungabi namandla, abe nezimpawu ezengeziwe, eziphazamisayo.

Izifundo zaselabhorethri zokungabi namandla zenziwa kuphela ngemva kokuqoqa inhlolovo ephelele kanye nokwenza izivivinyo zangaphakathi. Ngokusekelwe kudatha etholakalayo, udokotela ubeka isethi ethile yokuhlolwa kwaselabhorethri. Kufanele kuqashelwe ukuthi alukho uhlelo olulodwa olujwayelekile locwaningo, futhi isinqumo sihlala senziwa ngokwanele esimweni esithile.

Ingabe udinga ukubonisana nodokotela, i-e-issuance noma i-e-prescription? Iya kuwebhusayithi ethi abcZdrowie Thola udokotela futhi ngokushesha uhlele isikhathi sokulala esibhedlela nochwepheshe abavela kulo lonke elasePoland noma nge-teleportation.