The engineering analysis of bioheat equation and penile hemodynamic relationships in the diagnosis of erectile dysfunction: part I—theoretical study and mathematical modeling

Abstract

The extent to which skin surface bioheat perfusion predicts penile physiological response such as an erection has not been extensively investigated. A biomechanical engineering study was performed to compare bioheat distribution on penile skin surface resulting from an induced erection at steady state to examine the efficacy of such method as an adjunct tool for the diagnosis and classification of erectile dysfunction (ED) due to different etiology. We based our arguments on the principle that blood vessel activity and perfusion to corpus cavernosa at the erect state are almost always higher than that in the flaccid state. Our results showed that a difference of 0.1-0.3 1C can be observed and hence used to develop database of 'smart diagnosis' for ED using the machine artificial intelligence. It is anticipated that such basic research into blood flow is critical, as blood perfusion into corpus cavernosa is the most influential factor determining functional erectile quality contributing to successful coitus. Increased understanding of the hemodynamic response profile contributes toward optimal treatment and thus enables clinicians to adopt an appropriate management scheme for ED. IntroductionErectile dysfunction (ED) is the failure to develop and maintain erections of sufficient rigidity for penetrative sexual intercourse.1 In all cultures, the issue of ED has always been linked with masculinity; having the false believe that the capacity of a strong erection is a symbolic of strong men. The frequency of ED and its related research have not been well investigated, partially due to its sensitivity of information and respondents giving unreliable replies. The diagnosis of ED has also been held back by the lack of objective definition of the problems, and sometimes due to the reluctance of physicians and patients in carrying out certain conversations. However, the cause of ED are frequently multiple, with psychological, neurological, endocrinological, vascular, traumatic and chemical components being described. The precise role of environmental and lifestyle factors such as smoking, stress, hypertension and diabetes mellitus in the development of ED has been proposed as potential risk factors. The complexity of research in the area of sexual arousal of men is probably due to erectile function, which being a function of great evolutionary antiquity is very much subjected to erotic stimuli and can diminish over habituation. Experiments with animals have shown that rams introduced to fresh partners quickly restored the rates of intercourse compared with the male exposed to the same partner all the time. Rams introduced to the same partner have a much longer time to ejaculation compared with rams introduced to different partners at the same rate.2 Thus, ED, or many other sexual related diseases, are not always the failure of some biomechanical or biochemical process. The human sexual response is a complex, multifaceted phenomenon that is not completely, or nearly, understood by scientist or sexologist. To date, probabl...