Doc, you can say all you want, but my impotence is not psychological. Yes, that was someone from Lagos (name withheld). He read my piece last week, where I stated that 90% of “impotence or erectile dysfunction” is psychological. He vehemently disagreed with me, even quoting the Bible, alluding to what Jesus said before his crucification that “the spirit is willing, but the flesh is weak”.
Do you know that most men above 40, one way or the other experience sexual dysfunction. Most of those who called or sent texts messages complained of unsustained erection, especially those above 40. I counseled them, that most erectile dysfunction is psychological, but for those above 40 it could be due to Benign Prostatic Hypertrophy (BPH). I have had several feedbacks from my readers during my series on prostate enlargement. They reported encouraging improvement on their sexual lives after taking some anti enlargement prostate drugs like terazosin etc. Most of my patients worry was how to know if they have prostate enlargement. So let me dwell a little bit on the synopsis of the diagnosis of prostate enlargement and the resultant impotence.
Let me shock all of us. There is a new kid in the block. And the research is currently ongoing in Oxford University. It is based on the old English adage that “Familiarity breeds contempt”. The research like that above saying is based on the concept that when two people live together and become too familiar with each other, the stress of daily living and conjugal affiliation some how affect their sexual drive and subsequently the male libido declines. They are exploring the possibility of another English adage which says “variety is the spice of life”. That is whether couples could be discreetly advised to explore the variety option, stating that may be the pang of conscience they will feel for their indiscretion could improve their libido. Please do not say you read it from Dr Sun.
So if you are above 40, and experiencing any sexual inadequacies, please consult your doctor, who will ask detailed questions about your impotence, followed by physical examination which may include
Digital rectal examination – the doctor inserts a finger into the rectum to check your prostate enlargement. Palpation of the prostate becomes diagnostic of BPH.
Urine test – analysing a sample of your urine can help rule out an infection or other conditions that can cause impotence and BPH.
Blood test – the result will allow your doctor to rule out kidney problems, which could coexist with prostate enlargement.
Prostate Specific Antigen (PSA) – blood test of PSA which is a substance produced in your prostate. PSA levels increase when you have an enlarged prostate. However elevated PSA levels can also be due to recent procedures, surgery, infection or prostate cancer.
Urinary flow test – you urinate into a receptacle attached to a machine that measures the strength and amount of your urine flow. The test results help determine over time, if your prostate enlargement is getting better or worse, especially for those taking anti prostate enlargement drugs like terazosin etc.
Post void residual volume test – this test was introduced when it was discovered that most men above 50 with prostate enlargement and prostate surgery , had poor urinary flow, urethral stricture and retention of urine. This test measures whether you can empty your bladder completely, when you start the anti prostate enlargement drugs like terazosin. The test uses ultrasound or by inserting a catheter into your bladder after you urinate to measure how much urine is left in your bladder. People with BPH always have erectile dysfunction and urethral narrowing and a lot of urine is voided when they start the drugs.
Prostate biopsy – Trans rectal ultrasound guides needles used to take tissue samples (biopsies) of the prostate. Examining the tissue can help your doctor diagnose or rule out prostate cancer. So the causes of impotence or other sexual dysfunction could be narrowed down to psychological factors, prostate enlargement or prostate cancer. Always be medically guided.
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