Erectile Dysfunction — Start With an Investigation, Not a Pill
What causes it, and how the cause is identified precisely.
What is the problem?
Erectile dysfunction is a recurring difficulty in achieving or maintaining an adequate erection. What matters is that it is a result rather than a disease in itself — and there is a cause behind it that can be identified.
And the most common cause is not psychological, contrary to what is assumed. An erection is primarily a matter of blood flow, which is why its weakness is sometimes the first sign of a problem in the arteries, in diabetic control or in hormones — appearing here before it appears anywhere else.
Why this matters more than it appears
The complaint may be an early warning rather than a marital problem.
A man who buys pills from a pharmacy without investigation may treat the symptom and leave its cause to grow silently.
The investigation here does not concern your marital life alone — it concerns your general health.
How we examine it here
Penile Doppler erection study: an investigation that measures blood flow within the organ and its capacity to achieve an erection. It answers the most important question: is the problem in blood arriving, in blood being retained, or outside the circulation altogether?
- Time in clinic
- 30 minutes.
- Anaesthetic
- None.
- Equipment
- Doppler — ultrasound imaging of blood flow.
- Who is present
- The doctor and one assistant — a fixed protocol.
- Where it is done
- Inside the centre — no external referral.
- Follow-up
- One review after a week to read the result and explain the plan.
Which tests are usually requested?
Erectile dysfunction often originates outside the organ itself. The investigation is therefore usually accompanied by laboratory assessment that looks for the cause across the whole body:
- Total testosterone
- Reveals hormone deficiency as a cause in its own right. It is drawn specifically in the morning.
- HbA1c or fasting glucose
- Diabetes is among the most common causes of erectile dysfunction, and this may be its first presentation.
- Blood lipids
- Raised lipids narrow the small arteries, and the arteries of the organ are among the first affected.
- Thyroid function
- Thyroid imbalance — over or under — affects desire and erection together.
- Additional hormones where needed
- Requested when testosterone deficiency appears, to locate the source of the problem precisely.
Timing is part of the test
Testosterone is drawn in the morning, between seven and eleven.
A sample drawn in the evening gives a figure lower than the truth, and can lead to a wrong diagnosis and a treatment you do not need.
Dr Mohammed Shaker Hito
Consultant Urological and Genital Surgeon
Medical Director, Hokama Najd Medical Polyclinic
More than forty years of experience in urological and genital surgery — he began practising the specialty in 1984.
Holds German accreditation in his specialty.
Oversees the centre's approved medical service list as Medical Director; it is signed in his name.
Performs the diagnostic investigations himself in the clinic: uroflowmetry, post-void residual, prostate volume, cystoscopy, Doppler and the erection study.
Follows the case from examination through reading the result to the plan — patients are not passed between different hands inside the clinic.
This experience is what explains the clinic's approach: four decades in the specialty teach that most of what gets treated by guesswork could have been settled by a single investigation at the outset.
Questions and answers
Questions frequently asked about erectile dysfunction at the urology clinic at Hokama Najd.
It is a medical investigation using imaging equipment, carried out in a closed room with only the doctor and one assistant present. Our rule is that the type of procedure is never spoken aloud at reception.
It requires no anaesthetic.
Thirty minutes in the clinic, with the result read at a review one week later.
Not usually. That is exactly what the investigation settles rather than guessing — if blood flow is entirely normal, the search moves to another pathway.
Yes. The complaint appearing at a younger age calls for earlier investigation, not longer delay.
Yes. The investigation requires preparation and a reserved room — it is not done in a walk-in visit.
Book an examination appointment — the cause is identified before any treatment plan.
Book an Examination