Impotence - hunhu, zvikonzero, kuongororwa bvunzo dzekushaya simba

Kushaya simba idambudziko revarume vakawanda. Panogona kuva nezvikonzero zvakawanda zvekushaya simba. Vamwe varume vanonetsekana nekusashanda zvakanaka kwe erectile kana kushaikwa zvachose nekuda kwekushandisa mamwe ma pharmacological agents. Mune zvimwe zviitiko, kushaya simba kunobatanidzwa nemafungiro epfungwa akadai sekuzvidya mwoyo, kushungurudzika kwekare, uye penis duku yakaoma. Nhanho yekutanga yekuongorora erectile dysfunction ndeyekutora nhoroondo yezvehutano yakadzama. Munguva yekuongorora, chiremba anoedza kupindura mubvunzo wekuti erectile dysfunction ndeye organic (inokonzerwa nechirwere) kana psychogenic. Mushure mekuongororwa kwekutanga, chiremba anokurudzira mamwe matanho, angasanganisira kuongororwa kwerabhoritari yekushaya simba.

1. Hunhu uye zvinonyanya kukonzera kushaya simba

Kusasimba mutsa kusagadzikana kwemurume. Dambudziko iri rinowanzobata varume vakura, asi uyu handiwo mutemo. Zvinoitika kuti kushaya simba kunobata varume vechidiki. Kushaya simba kunoreva matambudziko anotevera: kusashanda zvakanaka kwemboro, kusakwana, kushaikwa zvachose, matambudziko ekumira, kurasikirwa kana kuderera kwekunzwa kwepabonde. Kushaya simba kunowanzoitika nekuda kwekusafamba zvakanaka kweropa. Iyi mamiriro inoreva kuti murume haagone kuwana erection yakazara kana yekusingaperi.

Auto zvinonyanya kukonzera kushaya simba:

• psychogenic impotence - inogona kuve yakabatana nekushushikana kusagadzikana, kushungurudzika, diki penis yakaoma, kushushikana kwemamiriro ezvinhu, kuderera kuzvidzora, ungochani.
• Hormonal impotence - inogona kukonzerwa nekuderera kwakanyanya kwe testosterone mazinga kana yakawandisa prolactin mazinga mumuviri.
• kushaya simba kweropa - kunogona kukonzerwa ne arterial hypertension, atherosclerosis, kana shanduko mutsinga dzeropa dzepeni.
• Kushaya simba kwezvinodhaka kunowanzobatanidzwa nemishonga yeBP, antidepressants, uye zvinodhaka zvinonzi antipsychotics.
• neurogenic impotence - inoitika muvarume vane kukuvara kwemusana, discopathy, muvanhu vanovimba nezvinhu zvepfungwa. Zvinowanzokonzeresa kushaya simba kweneurogenic zvakare matambudziko etsinga, sitiroko, kana mamota europi.

Mune 1/4 yevarume, nyanzvi dzinoongorora izvo zvinonzi kusanganiswa kusasimba.

2. Kuongororwa kwekushaya simba

Nhanho yekutanga yekuongorora erectile dysfunction ndeyekutora nhoroondo yezvehutano yakadzama. Panguva yekushanyira kuhofisi, chiremba anoongorora zvakakwana peni uye testicles. Mukuwedzera, nyanzvi inoitisa bvunzo yekufungidzira yekunzwa kweganda. Zvinonyanya kukosha kuyera BP yemunhu ari kushaya simba. Chiremba anofanirwawo kuongorora kugoverwa kweropa kumucheto wemurwere (kuongororwa kwegorofu uye pasi pasi zvakakodzera). Munguva yekuongororwa kwekliniki, kuongororwa kwetsinga kunoitwawo kuongorora mamiriro ehutano hwemurwere.

Kuongororwa kwe latency ye bulbocavernosal reflex haisi chinhu kunze kwedianostic nzira yekuongorora bulbocavernosal reflex. Panguva yokuongorora, chiremba anopinza munwe wegirovhosi murectum uye osvina nhengo yemurwere zvishoma. Mushure mekudzvanya pachirume, unofanirwa kunzwa kudhonzerana murectum nemunwe wako.

2.1. Zvidzidzo zverabhoritari zvakaitwa mukuongororwa kwekushaya simba

Zvidzidzo zverabhoritari zvakaitwa mukuongororwa kwekushaya simba:

• chepuraimari kuongororwa kweropa Anemia inogonawo kukonzera kuneta kusagadzikana kwe erectile,
• mazinga eglucose muropa serum uye weti - kusabvisa chirwere cheshuga mellitus,
• kutsunga kweiyo lipid profiles - inobvumidza iwe kuona huwandu hwecholesterol. Chiyero chepamusoro chinogona kuratidza njodzi yeatherosclerosis, iyo inovhara ropa kupeni.
• thyroid function assessment (TSH, fT4) - thyroid hormone inokanganisa kugadzirwa testosterone. Naizvozvo, kushomeka kwehomoni yethyroid kunogona kukanganisa erectile dysfunction,
• kuongororwa kwerenal (urea, creatinine) uye chiropa parameters (chiropa enzymes, bilirubin), iyo inobvumira kuongorora basa remitezo iyi,
• general urinalysis - kuwedzera pakuvapo kweglucose (kuonekwa kwechirwere cheshuga mellitus) inogona kuratidza chirwere cheitsvo,
• PSA inonzi antigen inotarirwa muzvirwere zveprostate gland.

Mune zvimwe zviitiko zvakaoma, kana kana kurapwa kunenge kwataurwa zvichibva pakuongororwa kwazvino kusingashande, zvimwe zvidzidzo zvakaoma zvekuwedzera zvinogona kuitwa kuti zvione chikonzero chekusashanda zvakanaka kwe erectile.

Special endocrinological bvunzo haiwanzo kuitwa. Vanowanzokurudzirwa kuvarume avo, kunze kwekusagadzikana kwe erectile, vanocherechedza kuderera kana kurasikirwa kwe libido (kuita zvepabonde), kurasikirwa kwehutano hwepabonde, zvakadai sebvudzi revarume. Izvi zvinosanganisira:

• testosterone mazinga - iyo hormone inotorwa mangwanani, kana iri pakukwirira kwayo muropa,
• prolactin - kunyanya mumajaya ane kurasikirwa kwe libido. Iyo yakakwirira yehomoni iyi inoderedza huwandu hwe testosterone muropa uye, kuburikidza nenzira isingazivikanwi, inobata yakaderera libido uye erectile dysfunction
• LH/FSH.

3. Ultrasound yenhengo yesikarudzi

Ultrasound yepeni ndechimwe chishandiso chekuongorora chinokutendera kuti uongorore mamiriro ehutano hwemurwere. Mukuongororwa kwekushaya simba, nyanzvi dzinoshandisa Ultrasound yetsinga dzakadzika dzemboro. Uyu muedzo unoitwa mushure me intracavernous administration yevasodilators. Muedzo unoitwa kana vascular erectile dysfunction ichifungidzirwa. Chinangwa chebvunzo ndechekuratidza kuyerera kweropa kwakaringana mumidziyo yepeni, uye kana paine kutyorwa, kuongorora kana dambudziko racho rakavharirwa kupinda kana kubuda kweropa kubva pachirume.

Ongororo inotevera ndeye ultrasound yenhengo dzepelvic uye kuongorora kwe transrectal. Kutenda kune aya maturusi ekuongorora, chiremba anogona kuona mamiriro enhengo dzenzvimbo.

munzvimbo yepelvic. Izvo zvakare zvinogoneka kuziva zvinogona hypertrophy yeprostate gland (prostate).

Mukuongororwa kwekushaya simba, nyanzvi dzinoshandisawo ultrasound kuongorora kwe testicles uye epididymis. Nezviyedzo izvi, chiremba anogona kusimbisa kana kubvisa kusashanda kwenhengo idzi. Uyu muedzo unonyanya kukosha apo murwere anotambura nehomoni erectile dysfunction (ane mazinga e testosterone akaderera).

4. Dzimwe nzira dzekuongorora kushaya simba

Pamusoro pekuongororwa kwema laboratory uye ultrasound, kune dzimwe nzira dzekuongorora kushaya simba. Parizvino, nzira inowanzoshandiswa yekuongorora ndiyo jekiseni rekuedza mukati me cavernous body yepeni. Intracavernous injection ndeye

vasodilator inobayiwa mumuviri wecavernous (kazhinji alprostadil inofananidzira prostaglandin). Kuwana erection mushure mekutonga kwezvinodhaka hazvibatanidzi chikonzero chevascular sechikonzero chekushaikwa kwekugadzirisa. Iyo nzira inogona zvakare kushandiswa senge mushure mekurapa kwe erectile dysfunction. Varume vazhinji vanotya jekiseni iri, pamwe chete nematambudziko anogona kuitika kana uchishandisa jekiseni rekuyedza. Iyo nzira inogona kukonzera fibrosis panzvimbo yejekiseni yemurwere. Pakati pezvimwe zvinonetsa, vanachiremba vanotaura mapundu, mavanga uye kukombama kwesikarudzi.

Imwe nzira yekuziva kushaya simba kuongororwa kwekumira kwesikarudzi yesikarudzi, inova ongororo isina kurongwa. Kuongororwa kwehusiku penile erection inogona kuona kana matambudziko erection anokonzerwa nepfungwa kana organic zvinhu. Panguva yehusiku hwekurara kweREM, kazhinji pane 3-5 penile erections. Psychiatric erectile dysfunction inoratidzwa neyakajairwa nocturnal erections, nepo organic erectile dysfunction haina kuwanda kana kusavapo.

Arteriography yemukati iriac arteri haisi chinhu chinopfuura chidzidzo chekufungidzira, chisingawanzoitwa, kunze kwezviitiko apo erectile dysfunction inokonzerwa nekushungurudzika kana kuvhiyiwa kwekare munzvimbo ino. Arteriography inobatsira kune vanhu vanogona kukwikwidza kuvhiyiwa kwevascular, senge vechidiki mushure metsaona.

Cavernosometry uye cavernosography bvunzo dzinokutendera kuti uone kukwira kweropa mukati memiviri ine cavernous uye kuona nzvimbo dzekuwedzera venous kubuda, izvo zvinoita kuti erectile dysfunction. Muedzo uyu unosanganisira kupinza tsono diki mbiri musikarudzi nekubaya jekiseni resaline, mushonga wekumisikidza, uye x-rays.

Chidzidzo chekunzwa kwekudengenyeka inzira yekuongorora iyo inobvumira zvakakurumidza, uwandu (zvine chinangwa), kuongororwa kwevarwere vekunze kwekunzwa kwekunzwa, iyo ndiyo imwe yezviratidzo zvakanyanya zvekunzwa neuropathy. Murwere achaitwa bvunzo yekunzwa kuzunguzika anofanira kusvika kuhofisi akazorora uye akazorodzwa. Usasvuta usati waongororwa. Nhamba dzinoratidza kuti muchirimo nematsutso inguva dzakanakisa dzegore dzekutora bvunzo. Iyo vibration sensation bvunzo inoshandiswa muvanhu vabatwa.

kuvhiringidzika kwekunzwa muchirwere cheshuga neuropathy.

5. Testosterone uye erectile dysfunction

Hormonal factors dzinoita basa rakakosha mukumira. Testosterone inoonekwa seyakakosha mahormone ekuita zvepabonde kwevanhu, asi basa rayo harisati ratsanangurwa zvizere. Zvinozivikanwa, zvisinei, kuti chimwe chezvikonzero zvekushaya simba ndiko kusagadzikana kwehomoni mu hypothalamic-pituitary-testicular system. Zvirwere zveimwe endocrine glands zvinokanganisa basa reiyi endocrine axis zvinogona zvakare kuve nemhedzisiro yakaipa. Zvisinei, inenge 5% chete yevarwere vanoona chiremba erectile dysfunction vane mazinga e testosterone akaderera. Zvidzidzo zvakawanda zvinoratidza kuti kudzikira kwemazinga e testosterone ndiko kukonzeresa kuderera kwe libido, kukura kusingaite kwehunhu hwechirume hwepabonde, uye kuora mwoyo. Nokudaro, kusarudza chiyero che testosterone yakasununguka inokurudzirwa kunyanya kune varume avo, kunze kwekushaya simba, vane zviratidzo zvekuwedzera, zvinoshungurudza.

Zvidzidzo zverabhoritari zvekushaya simba zvinongoitwa chete mushure mekuunganidza ongororo yakazara uye kuita bvunzo dzemukati. Kubva pane data iripo, chiremba anonyora imwe seti yekuongororwa kwema laboratori. Izvo zvinofanirwa kucherechedzwa kuti hapana imwechete yakajairwa chirongwa chekutsvagisa, uye sarudzo inogara ichiitwa zvakaringana kune chaiyo mamiriro.

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