Impotence - makhalidwe, zimayambitsa, matenda mayesero kusowa mphamvu

Kusowa mphamvu ndi vuto la amuna ambiri. Pakhoza kukhala zifukwa zambiri za kusowa mphamvu. Amuna ena amavutika ndi vuto la kusowa kwa erectile kapena kusowa kokwanira chifukwa chogwiritsa ntchito mankhwala enaake. Nthawi zina, kusowa mphamvu kumalumikizidwa ndi zinthu zamaganizidwe monga kusokonezeka kwa nkhawa, zowawa zam'mbuyomu, ndi zovuta zazing'ono za mbolo. Njira yoyamba yodziwira vuto la erectile ndikutenga mbiri yachipatala mwatsatanetsatane. Pakuwunika, dokotala amayesa kuyankha funso ngati erectile dysfunction ndi organic (chifukwa cha matenda) kapena psychogenic. Pambuyo pa matenda oyamba, adokotala amalimbikitsa njira zina, zomwe zingaphatikizepo kuyezetsa magazi kwa labotale ngati mulibe mphamvu.

1. Makhalidwe ndi zomwe zimayambitsa kusowa mphamvu

Kulephera okoma mtima kukanika kugonana amuna. Vutoli nthawi zambiri limakhudza amuna okhwima, koma ili si lamulo. Zimachitika kuti kusowa mphamvu kumakhudza amuna achichepere. Kupanda mphamvu kumatanthawuza mavuto otsatirawa: kusagwira bwino ntchito kwa mbolo, kusamalidwa bwino, kusowa kwathunthu, mavuto ogona, kutaya kapena kuchepa kwa chilakolako chogonana. Kupanda mphamvu kumachitika chifukwa cha kusayenda bwino kwa magazi. Izi zikutanthauza kuti mwamuna sangathe kukwaniritsa erection yathunthu kapena yokhazikika.

magalimoto zambiri zomwe zimayambitsa kusowa mphamvu:

• psychogenic impotence - imatha kulumikizidwa ndi vuto la nkhawa, kuvulala, zovuta za mbolo, kupsinjika kwa zochitika, kudzidalira, kugonana kwa amuna kapena akazi okhaokha.
• Kuchepa mphamvu kwa mahomoni - kumatha chifukwa cha kuchepa kwa testosterone kapena kuchuluka kwa prolactin m'thupi.
• circulatory impotence - angayambe chifukwa cha matenda oopsa, atherosclerosis, kapena kusintha kwa mitsempha ya mbolo.
• Kupanda mphamvu kwa mankhwala kumalumikizidwa ndi mankhwala othamanga kwambiri, antidepressants, ndi mankhwala otchedwa antipsychotics.
• Neurogenic impotence - amapezeka mwa amuna omwe ali ndi kuvulala kwa msana, discopathy, mwa anthu omwe amadalira zinthu za psychoactive. Zomwe zimayambitsa kusowa kwa mphamvu ya neuroogenic ndizovuta zamitsempha, sitiroko, kapena zotupa muubongo.

Mu 1/4 mwa amuna, akatswiri amazindikira zomwe zimatchedwa kusakwanira mphamvu.

2. Kuzindikira kuti alibe mphamvu

Njira yoyamba yodziwira vuto la erectile ndikutenga mbiri yachipatala mwatsatanetsatane. Paulendo wopita ku ofesi, dokotala amafufuza bwinobwino mbolo ndi machende. Kuonjezera apo, katswiriyo amayesa kuyesa kukhudzidwa kwa khungu. Ndikofunikira kwambiri kuyeza kuthamanga kwa magazi kwa munthu yemwe ali ndi vuto la kusowa mphamvu. Dokotala ayeneranso kuyesa magazi ku malekezero a wodwalayo (kuwunika kwa groin ndi m'munsi ndi koyenera). Pakuwunika kwachipatala, kuyezetsa kwaubongo kumachitikanso kuti awone momwe dongosolo la mitsempha la wodwalayo lilili.

Kuwunika kwa latency ya bulbocavernosal reflex sichinthu choposa njira ya dianostic yowunika bulbocavernosal reflex. Akamamuyeza, katswiriyo amalowetsa chala chotchinga m’khoko ndi kufinya pang’ono mbolo ya wodwalayo. Mukakanikiza mbolo, muyenera kumva kugwedezeka kwa rectum ndi chala chanu.

2.1. Laboratory maphunziro ikuchitika mu matenda a kusowa mphamvu

Laboratory maphunziro ikuchitika mu matenda a kusowa mphamvu:

• zoyambira kuyesa magazi Kuperewera kwa magazi m'thupi kungayambitsenso kutopa Kulephera kwa erectile,
• kuchuluka kwa glucose m'magazi a seramu ndi mkodzo - kupatula matenda a shuga,
• kutsimikiza kwa mbiri ya lipid - kumakupatsani mwayi wodziwa kuchuluka kwa cholesterol. Mlingo wapamwamba ukhoza kuwonetsa chiwopsezo cha atherosulinosis, chomwe chimalepheretsa magazi kupita ku mbolo.
• kuwunika ntchito ya chithokomiro (TSH, fT4) - mahomoni a chithokomiro amakhudza kupanga testosterone. Chifukwa chake, kuchepa kwa mahomoni a chithokomiro kumatha kusokoneza erectile dysfunction,
• kuwunika aimpso (urea, creatinine) ndi magawo a chiwindi (ma enzymes a chiwindi, bilirubin), omwe amalola kuwunika ntchito ya ziwalo izi,
• kukodza pafupipafupi - kuwonjezera pa kukhalapo kwa shuga (kuzindikira matenda a shuga) kungasonyeze matenda a impso,
• PSA ndi antigen yomwe imatsimikiziridwa mu matenda a prostate gland.

Muzochitika zovuta kwambiri, kapena pamene chithandizo chomwe chikuperekedwa potengera zomwe zikuchitika panopa sichikugwira ntchito, maphunziro owonjezera ovuta amatha kuchitidwa kuti adziwe chomwe chimayambitsa vuto la erectile.

Kuyesedwa kwapadera kwa endocrinological sikumachitidwa pafupipafupi. Nthawi zambiri amalangizidwa kwa amuna omwe, kuwonjezera pa kusokonezeka kwa erectile, amawona kuchepa kapena kutayika kwa libido (kugonana), kutaya makhalidwe ogonana, monga tsitsi lachimuna. Izi zikuphatikizapo:

• milingo ya testosterone - mahomoni amatengedwa m'mawa, akakhala m'magazi kwambiri,
• prolactin - makamaka mwa anyamata omwe ali ndi vuto la libido. Kuchuluka kwa hormone iyi kumachepetsa kuchuluka kwa testosterone m'magazi ndipo, kudzera mu njira yosadziwika, imakhudza kuchepetsa libido ndi kukanika kwa erectile
• LH/FSH.

3. Ultrasound ya mbolo

Ultrasound ya mbolo ndi chida china chodziwira matenda chomwe chimakupatsani mwayi wowunika momwe wodwalayo alili. Mu matenda a kusowa mphamvu, akatswiri ntchito Ultrasound ya mitsempha yakuya ya mbolo. Mayesowa amachitidwa pambuyo pa intracavernous makonzedwe a vasodilators. Kuyezetsa kumachitika ngati kukayikira kukanika kwa mitsempha ya erectile. Cholinga cha mayeso ndi kusonyeza olondola magazi mu ziwiya za mbolo, ndi nkhani ya kuphwanya, kuti azindikire ngati vuto ndi obstructed inflow kapena kutuluka kwa magazi kwa mbolo.

Kuyezetsa kotsatira ndi ultrasound ya ziwalo za m'chiuno ndi kufufuza kwa transrectal. Chifukwa cha zida zoyezetsa izi, dokotala amatha kudziwa momwe ziwalo zokhazikika zilili.

m'dera la pelvic. Ndizothekanso kuzindikira hypertrophy ya prostate gland (prostate).

Pozindikira kuti alibe mphamvu, akatswiri amagwiritsanso ntchito ultrasound ya testicles ndi epididymis. Ndi mayeserowa, dokotala akhoza kutsimikizira kapena kuletsa kusagwira ntchito kwa ziwalozi. Mayesowa ndi ofunikira makamaka pamene wodwala akuvutika ndi vuto la hormonal erectile dysfunction (ali ndi testosterone yochepa).

4. Njira zina zodziwira kupanda mphamvu

Kuphatikiza pa kuyesa kwa labotale ndi ultrasound, pali njira zina zodziwira kuti palibe mphamvu. Pakalipano, njira yodziwira matenda yomwe imagwiritsidwa ntchito kawirikawiri ndi jekeseni woyesera mu cavernous thupi la mbolo. Intracavernous jekeseni ndi

vasodilator amabayidwa m'thupi la cavernous (nthawi zambiri alprostadil ndi analogue ya prostaglandin). Kupeza erection pambuyo makonzedwe a mankhwala kusaphatikizapo mtima chifukwa chifukwa cha kusowa erection. Njirayi ingagwiritsidwenso ntchito ngati chithandizo cham'mbuyo cha vuto la erectile. Amuna ambiri amawopa jekeseniyi, komanso zovuta zomwe zingachitike pogwiritsa ntchito jekeseni woyesera. Njirayi imatha kuyambitsa fibrosis pamalo obaya jekeseni wodwala. Mwa zovuta zina, madokotala amatchula tokhala, mikwingwirima ndi kupindika kwa mbolo.

Njira ina yodziwira kupanda mphamvu kuunika kwa kugona kwa usiku kwa mbolo, komwe ndi kufufuza kosakonzekera. Kuwunika kwa usiku wa penile erection kumatha kudziwa ngati vuto la erection limayamba chifukwa chamalingaliro kapena organic. Usiku wa kugona kwa REM, nthawi zambiri pamakhala ma erections a 3-5. Psychiatric erectile dysfunction imadziwika ndi kukomoka kwabwino kwausiku, pomwe organic erectile dysfunction simapezeka kawirikawiri kapena kulibe.

Arteriography ya mtsempha wamkati wamkati siwongowonjezerapo kafukufuku wojambula zithunzi, zomwe sizichitika kawirikawiri, kupatulapo pamene vuto la erectile limayamba chifukwa cha kuvulala kapena opaleshoni yam'mbuyomu m'derali. Arteriography ndi yothandiza kwa anthu omwe angathe kuchitidwa opaleshoni ya mitsempha, monga achinyamata pambuyo pa ngozi.

Cavernosometry ndi cavernosography ndi mayeso omwe amakulolani kuti mutsimikizire kuthamanga kwa magazi mkati mwa matupi a cavernous ndikuzindikira malo omwe amatuluka kwambiri, zomwe zimapangitsa kuti erectile iwonongeke. Kuyezetsako kumaphatikizapo kulowetsamo tingano ziŵiri zing’onozing’ono mu mbolo ndi kubaya saline, mankhwala odzudzula, ndi ma x-ray.

Kusanthula kwa kugwedezeka kwamphamvu ndi njira yodziwira yomwe imalola kuti mwachangu, mochulukira (molinga), kuunika kwapanja kwa kunjenjemera kwa kugwedezeka, chomwe ndi chimodzi mwazinthu zodziwika bwino za neuropathy. Wodwala amene adzayezedwe kugwedezeka kwa mphamvu ayenera kufika ku ofesi atapumula komanso kutsitsimutsidwa. Osasuta musanayesedwe. Ziwerengero zikuwonetsa kuti masika ndi nthawi yophukira ndi nthawi yabwino kwambiri pachaka yoyeserera. Mayeso a vibration sensation amagwiritsidwa ntchito mwa anthu omwe akhudzidwa.

kusokonezeka kwamalingaliro mu diabetesic neuropathy.

5. Testosterone ndi erectile kukanika

Zinthu za mahomoni zimagwira ntchito yofunika kwambiri pakukweza. Testosterone imatengedwa kuti ndi yofunika kwambiri pa kugonana kwaumunthu, koma udindo wake sunafotokozedwe bwino. Zimadziwika, komabe, kuti chimodzi mwazomwe zimayambitsa kusabereka ndi kusokonezeka kwa mahomoni mu hypothalamic-pituitary-testicular system. Matenda a ma endocrine glands ena omwe amasokoneza ntchito ya endocrine axis amathanso kukhala ndi vuto. Komabe, pafupifupi 5% yokha ya odwala omwe amawona dokotala chifukwa cha vuto la erectile ali ndi ma testosterone otsika. Kafukufuku wambiri akuwonetsa kuti kuchepa kwa testosterone kumayambitsa kuchepa kwa libido, kukula kwachilendo kwa machitidwe ogonana amuna, komanso kukhumudwa. Choncho, kudziwa mlingo wa testosterone waulere kumalimbikitsidwa makamaka mwa amuna omwe, kuwonjezera pa kusowa mphamvu, amakhala ndi zizindikiro zowonjezera, zosokoneza.

Maphunziro a labotale okhudzana ndi kusowa mphamvu amachitidwa pokhapokha atatolera kafukufuku wokwanira ndikuyesa mayeso amkati. Kutengera ndi zomwe zilipo, dokotala amalemba mayeso a labotale. Tiyenera kuzindikira kuti palibe ndondomeko imodzi yofufuza kafukufuku, ndipo chisankhocho chimapangidwa nthawi zonse mokwanira pazochitika zenizeni.

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