The erection process requires the coordination of interactions between the arterial, venous, nervous and capillary systems. There are sexually stimulated erections that start as a nervous signal in the brain and require neurotransmitter balance and adequate dopamine.
The signal then follows the parasympathetic nervous pathway to the penis where the smooth muscle of the arteries in the penis relax and allow blood to flow into the penis at increased rate and pressure. Once erect, orgasm and ejaculation are dependent on the sympathetic nervous system, and contraction of pelvic bowl muscles. The quantity of ejaculate volume contributes significantly to the pleasure and intense feeling of ejaculation.
There are many reasons why there is penile dysfunction; from decreased sensitivity, to poor arterial blood flow, to neurological compromise, to back injuries, nerve impingement and more. Proper and thorough evaluation is extremely important in order to regain normal healthy function.
Penile evaluation should include a Penile Duplex Doppler Ultrasound. A Penile Duplex Doppler Ultrasound is a painless test done in the office that looks at the health of your penis, the blood flow in and out of your penis, your prostate, testicles and general pelvic area, to fully evaluate your penis and help to uncover the cause of your ED problem.