Loannis loannidis


A 32 year old married man visits his family doctor with complaints of progressive loss of erectile ability. He has been suffering from Type 1 DM for 15 years, with relatively satisfactory control. Over the previous three years he has also experienced neuropathic type pains (coexistence of peripheral neuropathy signs) in the lower extremities. In the past he had observed larger fluctuations in his blood sugar levels.

Initially his main problem was the inability to maintain erections so that he could achieve a satisfactory sexual contact. During the last six months, however, he also observed reduction in the quantity of sperm, despite preservation of orgasm. Very recently, he noticed the complete inability to achieve satisfactory erections.

His family doctor recommends that he speaks to a urologist.

Answers with regard to the reasons for this condition and its management are given below.

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