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Impotence

Impotence is an umbrella term used to describe male sexual malfunction and includes erectile dysfunction/failure (ED), ejaculatory and orgasmic abnormalities etc. However, in common parlance, impotence is taken to be synonymous with ED and both terms are often used interchangeably. For the purpose of the subject being discussed, this article will concentrate on ED and smoking. Erectile dysfunction (ED) is the inability to achieve or maintain an erection sufficient for satisfactory sexual function as defined by the American National Institute of Health Consensus Panel in 1992.

What Causes Impotence?
Failure of erection can be of organic or psychogenic origin. Organic causes are more common in the older population (over 70% in those 55 years or above), while psychogenic causes are commoner in the younger population. The common risk factors for organic impotence are diabetes mellitus, atherosclerosis (arterial disease), trauma, neurological conditions, drugs and smoking in no particular order.

How Does Smoking Cause Impotence?
To appreciate the relationship between smoking and ED, we need to understand the bio-mechanical basis of erection. Erection of the penis is a vascular event that entails a rapid inflow of blood through the arteries into the penile tissue spaces within a short time to achieve engorgement/tumescence and subsequently the penis stays rigid when blood outflow from the veins is blocked by the expanded penile spaces. Thus any disease process or drug that adversely affects blood flow in our body has the potential to cause impotence.

Smoking through the effect of nicotine on arteries is a recognized risk factor (among others) for arterial disease. Diseased arteries have narrowing of their lumens (like clogged pipes) and therefore, the rapid inflow of blood described above is not possible resulting in failure of erection. This is essentially the same mechanism for smoking-related heart disease, stroke etc. This adverse relationship between smoking and ED is well known among experts that treat impotence. And numerous medical reports continue to implicate smoking in majority of cases of impotence.

Conclusion
In summary, smoking is a scientifically recognized risk factor for organic erectile dysfunction in the male through its effects on the arteries. This risk increases with: age of patient, how long the individual has been a smoker, the number of cigarettes smoked per day, and other co-existing illnesses.
IF YOU DO NOT WISH TO BE IMPOTENT AT SOME POINT IN YOUR LIFE, THE TIME TO STOP SMOKING IS NOW!!!!

Contributed by:
Dr. Aloy Okeke, FMCS, FRCS
Specialist Registrar in Urology
Department of Urology
Southmead Hospital
Bristol, U.K.

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