- 607.84 Impotence of organic origin
- N52.9 Male erectile dysfunction, unspecified
- As of November 2012, the APTA Guide to Physical Therapist Practice does not include practice patterns for organ system pathology; associated or secondary musculoskeletal, cardiovascular/pulmonary, or potential neuromuscular patterns are indicated.
- Inability to perform sexually; inability to form an erection
- Loss of erection from arterial, venous, neurogenic, or psychological reasons
- Physical therapists treat secondary problems: weakness, gait abnormalities, limited aerobic endurance
- May be acute, post-operative, chronic, or congenital/hereditary; related to medication or other pathology
- Diagnosis usually based on history; need for targeted diagnostic procedures if neurogenic causes suspected
- Can have organic or psychosocial basis
- Organic basis may be early sign of cardiovascular disease
- Can result from spinal cord injury
- Incidence increases with age
- Psychological pathology
- Chronic ED affects1
- 4% of men in their 50s
- Approximately 17% of men in their 60s
- Approximately 47% of men over the age of 75 years
- Transient ED and inadequate erection
- Affect approximately 50% of men between the ages of 40 and 70 years
- Erectile dysfunction; inability to form or maintain an erection
- Premature ejaculation
- Prostatic enlargement
- Penile discharge
- Inability to procreate
- Inability to have an erection, sexual dysfunction
Possible Contributing Causes
- Urinary tract infection (bacterial or viral)
- Diabetes (type I or II) and associated medications
- Enlarged prostate
- Cardiac and hypertension medications
- Antihypertensive and antidepressant medications
- Damage to nerves, such as with multiple sclerosis, Parkinson’s, trauma
- Weak pelvic floor muscles
- Smoking (cancer-related)
- Occupational exposures
- Tumors (benign or metastatic)
- Spinal cord injury or neuromuscular pathology, such as stroke
- Post-surgical scarring or adhesions
- Side-effect of cancer treatment: radiation, chemotherapy, surgery
- Pathogen identification
- Complete blood count
- Lipid profile
- Radiography for spine involvement
- CT and MRI for spinal involvement, tumor
- Abdominal scans for possible tumor
- Palpation for differential diagnosis
- Kidneys: in supine, place one hand under client between ribs and iliac crest, other hand on abdomen below ribs and ribs pointing in opposite direction: +/- tenderness or reproduction of symptoms
- Bladder (not usually palpable unless distended and raised above pubic bone): in supine, place hand above pubis, press down: +/- tenderness, reproduction of pain, or ability to feel the bladder: __+ __-
- Discontinue medications that may be causal
- Penile surgical implants...
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