TESTOSTERON REPLACEMENT THERAPY PADA DISFUNGSI EREKSI OLEH KARENA DIABETES MELITUS
DOI:
https://doi.org/10.23887/penjakora.v1i1.11206Abstract
Disfungsi seksual banyak terjadi di masyarakat, baik pada pria maupun wanita, walaupun belum ada data yang pasti tentang insidennya. Salah satu disfungsi seksual pada pria yang sering dijumpai adalah disfungsi ereksi. Diduga tidak kurang dari 10% pria menikah di Indonesia mengalami disfungsi ereksi. Disfungsi ereksi lebih sering terjadi pada penderita diabetes melitus dibandingkan dengan populasi umum. Sekitar 30%-90% pria dengan diabetes melitus akan menderita disfungsi ereksi. Sejak ditemukannya PDE-5 (Phosphodiesterase type 5) inhibitors untuk terapi disfungsi ereksi testosteron telah dikesampingkan sebagai terapi pilihan pada disfungsi ereksi. Tetapi sebesar 50% pria yang diterapi dengan PDE-5 inhibitors menunjukkan kegagalan. Hal ini menimbulkan ketertarikan pada terapi disfungsi ereksi dengan hormon testosterone. Hormon testosteron mempunyai peranan yang besar pada jaringan penis termasuk dalam mekanisme ereksi, memelihara dan mempertahankan integritas struktur jaringan erektil. Kekurangan testosteron akan menyebabkan gangguan pada anatomi dan fisiologi jaringan erektil, gangguan pada serabut saraf kavernosal. Secara histologis, gangguan yang nampak pada jaringan erektil penis adalah kehilangan serat-serat elastin pada tunika albuginea dan otot polos korpus kavernosum, digantikan oleh jaringan kolagen pada kedua struktur tersebut, terjadinya kebocoran pada vena (venous leakage) sehingga menyebabkan terjadinya venous reflux dan terjadilah gangguan ereksi. Penurunan 50% testosteron pada sirkulasi akan menyebabkan terjadinya penurunan tekanan darah intrakavernosal. Pada penderita diabetes melitus dengan disfungsi ereksi, pemberian testosteron akan dapat meningkatkan ketebalan otot polos korpus kavernosum sehingga dapat memperbaiki fungsi ereksi.
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