Neurogenic causes of ED
Did you know that research shows 10 to 19% of ED cases are of neurogenic origins? An erection is a neurovascular event. Any medical condition or disease that affects the brain, cavernous and pudendal nerves, or spinal cord can induce dysfunction.
Pathological processes can affect regions that are the centres for sexual drive and sexual arousal. Conditions such as stroke, Parkinson’s disease, temporal lobe epilepsy or encephalitis are often associated with ED. Other brain-related ailments that are associated with ED are dementia, tumours, Alzheimer’s disease, trauma and Shy-Drager syndrome etc.
For those with spinal cord injuries, the erectile function depends on the location, nature and extent of spinal lesion. Another side effect of the same type of injury could be impaired ejaculation or orgasm. Other disorders which have been linked to erectile dysfunction include spina bifida, syringomyelia, disc herniation, transverse myelitis, tumour, and multiple sclerosis.
There is a close relationship between the pelvic organs and the cavernous nerves and surgery on these organs is a frequent cause of ED. However, there has been an improved understanding of the neuroanatomy of the cavernous nerves and pelvic organs which has resulted in modified surgeries reducing the percentage of ED as an after effect. For instance the introduction of nerve-sparing radical prostatectomy has reduced the likelihood of impotence from 100% to 30–50%.
ED in cases of pelvic fracture can result from cavernous nerve injury, vascular insufficiency or both.
Men will typically experience a decrease in penile tactile sensitivity as they increase in age. Sensory input is important for achieving and maintaining reflexogenic erections. This input becomes all the more important as an individual grows older. A sensory evaluation in such cases should be an integral part of the evaluation for ED for those with or without any neurologic disorder.
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