AN ASSESSMENT OF ERECTILE DYSFUNCTION AMONG THE NIGERIAN YOUTHS

CHAPTER ONE

INTRODUCTION

Background Of The Study

According to the International Consultation on Sexual Medicine, erectile dysfunction (ED) is characterised by the persistent and recurring inability to attain or maintain an erection that is both sufficiently rigid and long-lasting to allow for adequate sexual activity. In spite of its comparatively elevated incidence, understanding of ED was restricted until the 1970s (Krassas 2019). Subsequent to that period, enormous strides have been made in molecular biology techniques that significantly enhance our comprehension of penile physiology and the pathogenesis that underlies ED. Coordination between psychological, neurological, and vascular pathways is required to attain an erection; these pathways collaborate to stimulate a physiological response in the vasculature of the penis. The penile cavernosal tissue, in reaction to parasympathetic signals transmitted from the pelvic and pudendal splanchnic nerve plexuses, secretes nitric oxide (NO) (Lambert, 2021). By reducing intracellular calcium via cyclic guanosine monophosphatee, NO induces relaxation of cavernosal smooth muscle. By obstructing venous outflow from the penis through vein compression against the tunica albuginea, filling of the cavernosal sinusoids permits erection maintenance (Safarinejad 2020). Hypoxia-induced elevation of cyclic guanosine monophosphate is reversed by phosphodiesterase type 5 (PDE5). Adrenergic receptor activation facilitates detumescence by causing rhythmic contraction of the cavernosal smooth muscle; this, in turn, stimulates venous outflow by promoting a reduction in arterial diameter. The potential for disruptions in the psychological and physiological pathways that lead to ED in young men is extensive, considering the intricate nature of these pathways. 

Historically, ED has been regarded as a disease that is dependent on age, with the majority of males manifesting symptoms of ED subsequent to reaching the age of 65. Recent research, however, has shown an increase in the incidence of ED among men under the age of 40; this trend is likely underestimated due to younger patients' reluctance to disclose symptoms. It was previously postulated that ED in males below the age of 40 was predominantly of a psychogenic nature, until the 1970s (McCabe, Althof 2022). Therefore, prior to the 1970s, the diagnostic assessment of young males with ED primarily focused on gathering information regarding their sexual history and provided treatment options that were restricted to herbal supplementation and behavioural therapy. According to recent research, as elaborated in the subsequent sections of this review, up to 87 percent of young men diagnosed with ED also suffer from an organic component of their condition (vascular, neurologic, hormonal, fibrogenic, or medication-induced) (Ludwig & Phillips 2019).

Statement Of The Problem

ED is a critical health issue that exerts a substantial negative impact on an individual's quality of life and can negatively influence the psychosocial well-being of men. ED is one of the few conditions that will inspire young men to visit a urologist; therefore, practitioners must be more informed (Krassas 2019). Despite the progress made in ED detection and management through advancements in treatment (e.g., oral pharmacotherapy, intracavernosal injection [ICI] therapy, and penile prosthesis) and screening (e.g., penile duplex ultrasound, endocrine evaluation), it is still a prevalent occurrence for young men experiencing sexual dysfunction to be disregarded without a comprehensive investigation for non-psychogenic aetiologies (Ludwig, Phillips 2019). An update on the available data concerning the causes and effects of erectile dysfunction in adolescents is the objective of this review. In addition, the researchers strive to establish a guiding framework for clinicians to utilise when identifying young males with ED and to enhance the management of this expanding cohort of patients. (Young  2018).

1.3 Objectives Of The Study

The main aim of this study is to examine the causes and effects of erectile dysfunction among the youths. Specific objectives of this study include:

To determine the prevalence of erectile dysfunction among the youths.

To find out the level of youths’ knowledge of erectile dysfunction.

To find out the possible causes of erectile dysfunction among the youths.

To find out the effect of erectile dysfunction on the sexual health of the youths.

Research Questions

The following research questions will be answered in this study:

What is the prevalence of erectile dysfunction among the youths?

What is the level of youths’ knowledge of erectile dysfunction?

What are the possible causes of erectile dysfunction among the youths?

What is the effect of erectile dysfunction on the sexual health of the youths?

Research Hypotheses

The following null hypotheses will validate this study:

Ho: Erectile dysfunction has no effect on the sexual health of the youths.

Ha: Erectile dysfunction has an effect on the sexual health of the youths.

Significance Of The Study

This study will be greatly significant to the teeming youths as the findings of this study will prove beneficial and help bring a level of awareness about sexual health to the youths. This study will also serve as a reference point for further studies and future researches.

Scope Of The Study

This study is focused on the causes and effects of erectile dysfunction among the youths. Specifically, this study focuses on determining whether the youths are aware of erectile dysfunction, determining how prevalent erectile dysfunction is among the youths, etc. 

1.8 Limitation of the Study

Like in every human endeavour, the researcher encountered slight constraints while carrying out the study. Insufficient funds tend to impede the efficiency of the researcher in sourcing for the relevant materials, literature, or information and in the process of data collection, which is why the researcher resorted to a limited choice of sample size. More so, the researcher simultaneously engaged in this study with other academic work. As a result, the amount of time spent on research will be reduced.

Moreover, the case study method utilized in the study posed some challenges to the investigator including the possibility of biases and poor judgment of issues. However, the investigator relied on respect for the general principles of procedures, justice, fairness, objectivity in observation and recording, and weighing of evidence to overcome the challenges.

1.9 Definition Of Terms

Erectile dysfunction: Occurs when a man can't get or keep an erection firm enough for sexual intercourse.