Development of an Erection
 

      Sexual activity is the important part of human life. Erectile dysfunction becomes the serious issues that is a widespread and under-reported disorder affecting millions of men. With the aging of our population and age-related comorbid conditions, this problem is only going increase in magnitude.

      To understand the assessment and treatment of sexual dysfunction , it is necessary to first review development of an erection.

The Development of an Erection

could happen in 3 circumstances as follows:

1. Psycologinic Erection
is a vascular event initiated by neuronal action and maintained by a complex interplay between the central nervous system and factors. It may occur as a result of genital stimulation or psychic input (fantasy sight ,sound ,or smell ). Stimuli are processed in the hypothalamus, and neural impulses are transmitted to the thoracolumbar and sacral erection centers. The thoracolumbar center provides sympathetic innervations that maintains penile flaccidity .The sacral erection center provides parasympathetic innervations that leads to erection . (Increased parasympathetic activity result in and increased production of nitric oxide and vasoactive polypeptide. This result in an increased production of cyclic guanidine monophosphate : cyclic GMP ,that reduces intracellular calcium, resulting in smooth muscle relaxation and increased blood flow through the pudendal and cavernous arteries .)

 
     
 
      Parasympathetic input relaxes the trabecular smooth muscle and dilates the helicine arteries of the penis .This lead toexpansion of the lacunar spaces and entrapment of blood as increasing blood volume compresses venules against the tunica albuginea . This process is known as the corporal veno-occlusive mechanism .

2. Reflexoginic Erection This still follows the corporal veno-occlusive mechanism. But it may occur as a result of physical stimulation to the penis. The reflexoginic neural impulses are transmitted from penis directly to the thoracolumbar and sacral erection centers. Then the process returns.

3. Nocturnal Erection is poorly understood at the present time. It appears 4-5 time during the night when men are sleeping .It is believed that it is the oxygen stimulation process for penis muscles.

 
 
Normal Sexual Function

Arteries (top) and veins (bottom)
penetrate the long, filled cavities running the length of the penis—the corpora cavernosa and the corpus spongiosum. Erection occurs when relaxed muscles allow the corpora cavernosa to fill with excess blood fed by the arteries, while drainage of blood through the veins is blocked.
 


  Erectile Dysfunction

     The definition of “Erectile Dysfunction “ is the inability to achieve full erection through out sexual intercourse. Erectile dysfunction is the result of the effects of age association disease and /or their treatment one the ability to develop or maintain an erection. The etiology of erectile dysfunction may be broadly categorized as organic , psychogenic, or mixed.

      Organic causes may be vascular , neurogenic, hormonal , or pharmacologic. They may be related to surgery or radiation .Organic disorders account for the majority of all cases of erectile dysfunction.



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