What do we mean by erectile dysfunction?
The term “erectile dysfunction” (ED) defines the inability to achieve or maintain an erection with sufficient rigidity to permit having a satisfactory sexual intercourse.
Recent epidemiological studies have shown that the prevalence in our country is 12.1% of males between 25 and 70 years old, while 50% of individuals over 60 years old are affected. This number implies that between 1.5 and 2 million Spaniards suffer from ED, although it is calculated that only 16.5% of those affected consult a specialist.
How is an erection produced?
An erection is the result of a complex interaction between vascular, hormonal, neurological and psychological factors.
The penis is made up of three cylindrical structures: two columns called the corpora cavernosa (CC), which are covered in turn by a firm and elastic membrane called the tunica albuginea (TA), and a third column called the corpus spongiosum (CS), which encircles the tube of the urethra (U) (figures A, B and C). The corpora cavernosa are formed of very vascularised tissue that, like the cells of a sponge, is arranged in the form of trabeculae or sinusoids, tiny vascular spaces surrounded by smooth muscle. The blood enters the corpora cavernosa through the cavernosal arteries (AC).
When sexual stimulus occurs, the cavernous nerves allow the release of certain substances (principally nitric oxide) within the sinusoids, causing relaxation of the smooth muscle. This relaxation permits the flow of blood into the penis to increase by up to 20 times. In addition, the phenomenon of venous occlusion occurs: a closing of the veins that in a rest state drain the blood from the penis. In this way, a large delivery of arterial blood and a marked decrease in venous return produce an erection.