Urinary Health: Insights from Dr. Hsieh on Erectile Function

Thank you very much, Dr. Hsu?

Thank you, doctor, for patiently answering my questions.
Based on your first point: that urinary retention indicates normal erectile nerve pathways, and your second point: that we need to assess for nerve damage to determine if sexual function is affected by nerve issues, can I infer that my sexual ability is currently impacted but is likely not due to nerve damage? Since I experience urinary retention and still have instances of erection.
Thank you again for your thorough responses.
I will discuss this further with you during my next appointment.

bang z, 20~29 year old female. Ask Date: 2010/10/22

Dr. Xu Weikai reply Urology

Hello, it is not necessarily a nerve injury; sometimes, vascular damage can present similarly.
Additionally, regarding the first point, you may have misunderstood; it can only be said that the nerve conduction pathways are intact.
This does not imply that they are normal, as many individuals with erectile dysfunction can still experience reflexive erections due to bladder distension.
For example, even if the nerve pathways are not damaged, they may be narrower or conduct signals more slowly, which cannot be diagnosed solely through this reflex.
Furthermore, patients with spinal cord injuries may be unable to achieve erections on their own, but can still have erections due to bladder fullness; however, they cannot achieve erections through other stimuli (such as pornography).
In conclusion, individuals who experience reflexive erections due to bladder distension do not necessarily have normal sexual function.
Moreover, erections involve neural, vascular, and psychological components of arousal.
If there is an issue in any one of these areas, it can lead to erectile dysfunction.
If there are any problems, it is advisable to seek medical attention promptly to address the issue.

Reply Date: 2010/10/22

More Info

Understanding urinary health and its relationship with erectile function is a complex topic that involves multiple physiological systems, including the nervous, vascular, and endocrine systems. Based on the insights provided by Dr. Hsieh, it seems that you are trying to connect the dots between your urinary symptoms and erectile function, which is a common concern among many patients.

Firstly, the fact that you experience "urinary fullness" or "urge to urinate" indicates that the neural pathways responsible for bladder sensation and function are intact. This is a positive sign, as it suggests that the nerves controlling your bladder are functioning properly. In general, the ability to feel the need to urinate and to achieve an erection involves similar neural pathways, particularly those related to the autonomic nervous system. Therefore, if you are experiencing normal urinary sensations, it is likely that the nerves involved in erectile function are also functioning well.

However, erectile dysfunction (ED) can arise from various causes, including psychological factors, hormonal imbalances, vascular issues, and even medication side effects. Since you mentioned that you have experienced some erectile issues, it is essential to consider these other factors. For instance, psychological stress, anxiety, or depression can significantly impact sexual performance, even if the physiological pathways are intact. Additionally, conditions such as diabetes or hypertension can lead to vascular changes that affect blood flow to the penis, resulting in ED.

Dr. Hsieh's emphasis on checking for nerve damage is crucial. If there is no evidence of nerve injury, then the erectile dysfunction may not be due to neurological issues but rather other factors such as psychological stress or vascular health. It would be beneficial to discuss your complete medical history, including any medications you are taking, lifestyle factors (like diet and exercise), and any psychological stressors, during your next appointment.

Moreover, it is essential to consider the role of testosterone in sexual function. Low testosterone levels can lead to decreased libido and erectile dysfunction. If you have not had your hormone levels checked, it might be worth discussing this with your healthcare provider. They can perform blood tests to evaluate your testosterone levels and other relevant hormones.

In terms of self-care and lifestyle modifications, maintaining a healthy diet, regular exercise, and managing stress can all contribute positively to both urinary health and erectile function. Engaging in pelvic floor exercises (Kegel exercises) can also strengthen the muscles involved in sexual function and improve erectile performance.

Lastly, if you are experiencing persistent erectile dysfunction, it may be worthwhile to explore treatment options. Medications such as phosphodiesterase type 5 inhibitors (like Viagra or Cialis) can be effective for many men. However, it is crucial to consult with your healthcare provider to determine the most appropriate treatment based on your specific situation.

In summary, while your urinary sensations suggest that the neural pathways are functioning well, it is essential to explore other potential causes of erectile dysfunction. A comprehensive evaluation by your healthcare provider, including discussions about psychological factors, hormonal levels, and lifestyle modifications, will provide a clearer picture and guide you toward effective management strategies.

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