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Differential Diagnosis for a Man Unable to Sustain an Erection

Single Most Likely Diagnosis

  • Erectile Dysfunction (ED) due to Vascular Disease: This is often the most common cause of sustained erection issues in men, particularly those with a history of hypertension, diabetes, or hyperlipidemia. Vascular diseases can impair blood flow to the penis, making it difficult to achieve or maintain an erection.

Other Likely Diagnoses

  • Psychogenic Erectile Dysfunction: Psychological factors such as stress, anxiety, depression, or relationship issues can significantly impact a man's ability to sustain an erection.
  • Neurogenic Erectile Dysfunction: Conditions affecting the nervous system, such as multiple sclerosis, Parkinson's disease, or nerve damage from surgery or injury, can disrupt the nerve signals necessary for erection.
  • Hormonal Imbalance: Low levels of testosterone or other hormonal imbalances can affect libido and erectile function.
  • Medication-Induced Erectile Dysfunction: Certain medications, including antidepressants, antihistamines, and blood pressure medications, can cause erectile dysfunction as a side effect.

Do Not Miss Diagnoses

  • Peyronie's Disease: A condition characterized by the development of scar tissue inside the penis, leading to curved, painful erections. If missed, it can lead to significant discomfort and permanent damage.
  • Priapism: A condition where an erection lasts for more than four hours, which is a medical emergency requiring immediate attention to prevent tissue damage.
  • Testicular Cancer: Though rare, testicular cancer can cause hormonal imbalances leading to erectile dysfunction. Early detection is crucial for effective treatment.

Rare Diagnoses

  • Pudendal Artery Thrombosis: A rare condition where a blood clot forms in the artery supplying blood to the penis, which can cause sudden onset of erectile dysfunction.
  • Fabry Disease: A genetic disorder that can lead to vascular dysfunction, including erectile dysfunction, due to the accumulation of a particular type of fat in the body's cells.
  • Cavernosal Arterial Atherosclerosis: A condition where the arteries within the penis become narrowed due to atherosclerosis, impairing blood flow and erection.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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