Kɔtewuiɛ

Kɔtewuiɛ a wɔsan nso frɛ no **krawa**, yɛ nna mu haw wɔ mmarima mu a ɛma no yɛ den ma mmarima sɛ wɔn kɔte bɛsɔre agyina so mmerɛ kakra anaa sɛ ɛbɛyɛ den berɛ a wɔne ɔbaa rebɛhyia mu wɔ nna mu no.Ɛno ne nna mu haw pa ara wɔ mmarima so na ɛbɛtumi mpo ama obi anya adwenem haw ɛsiane sɛdeɛ nipa no hunu ne ho na ɔntumi ne ɔbaa nhyia mu no nti. 

Kɔtewuiɛ a adɔɔso no gyina nneɛma binom a yɛde yɛn ani hunu na ɛbɛtumi aha yɛn no ne deɛ yɛtumi susu no.Yɛbɛtumi akyekyɛ saa nneɛma yi mu sɛ vascular, neurological,local penile, hormonal, ne drug-induced.Kɔtewuiɛ ho nsusuiɛ no bi ne yareɛ a ɛnya nipadua no nyinaa,akoma ne mogya mu yareɛ, asikyire yareɛ, mogyaborosoɔ,ahonhono,mogya mu nsuo mmorosoɔ, yareɛ a wɔfrɛ no hypogonadism, nnubɔnenom, wobɛtɔ baha,ne nnuronom.Wɔde nsɛm ahodoɔ bɛyɛ sɛ ɔha mu nkyekyɛmu du(10%) ma adwenem ne nkitahodie a wobɛhunu nneɛma binom te sɛ, wobɛtɔ baha,brɛ, ne ayɔnkofa mu haw. Yareɛ a ɛne kɔtewuiɛ sesɛ no, ɛbi te sɛ priapism no nyɛ pɛ.

## Nsɛnkyerɛnne ne Mpopoeɛ
Kɔtewuiɛ yɛ adeɛ ɛyɛ den sɛ wobɛtumi ama kɔteɛ no asɔre na ayɛ den berɛ a nhyiamudie rebɛkɔ so no.Kɔtewuiɛ asekyerɛ ne sɛ worentumi mma wo kɔte nsɔre nyɛ den ma nhyiamudie nkɔso bɛyɛ abosome nsia.

## Deɛ ɛde ba
Nneɛma a ɛde kɔtewuiiɛ ba na ɛdidisoɔ yi:

* Nnuane a sradeɛ wɔ mu pii no de akoma yareɛ ba,na mpɛn pii no ɛnyɛ na koraa sɛ mmarima a wɔwɔ akoma yareɛ no tumi nya kɔtewuiɛ.  Ɛkwan bi nso no sɛ wodi nhahanma aduane a, ɛyɛ den sɛ wo kɔte bɛwu. 

* Nnuro a ɛyɛ (sɛ ebia SSRIs, beta blockers, antihistamines, alpha-2 adrenergic receptor agonists, thiazides, hormone modulators, ne 5a-reductase inhibitors)

* Adwenem haw(ɛbi te sɛ, diabetic neuropathy, temporal lobe epilepsy, multiple sclerosis, Parkinson’s disease, multiple system atrophy) 

* Cavernosal disorders (sɛ ebia; Peyronie yareɛ)
* Hyperprolactinemia (sɛ ebia; ɛsiane prolactinoma)
* Adwenemyare: mpamu agudie mu dadwene (performance anxiety), adwennwene ne adwennwenemu yareɛ  
* Surgery (sɛ ebia;radical prostatectomy)
* Nkwakoraabere: Sɛ wonyini duru mfeɛ aduanan de rekɔ a, nyini bɛyɛ adeɛ baako a ɛtumi de kɔtewuiiɛ ba, ɛwɔ mu yareɛ ahodoɔ bi a nyini tumi de ba, sɛ ebia testosterone deficiency, cardiovascular diseases, anaa asikyire yareɛ ne deɛ ɛkeka ho nyinaa no nso wɔ nsunsuansoɔ bi. 
* Kidney yareɛ: Kɔtewuiiɛ ne koankorɔ "kidney" yareɛ wɔ nneɛma bi a ɛyɛ pɛ a vascular hormonal dysfunction ka ho na wɔtumi kyɛ nneɛma binom nso, sɛ ebia sasaborɔ ne asikyire yareɛ a ɛtumi de kɔtewuiiɛ ba no. 

## Patofisiolɔgyi
Sɛ kɔteɛ bɛsɔre no, gyina nneɛma mmienu so: sɛ kɔteɛ no ara ankasa bɛsɔre, a ɛgyina sɛ wode wo nsa bɛka kɔteɛ no ano no, ɛne sɛ w’adwene no bɛma wo kɔte asɔre, a ɛgyina nneɛma bi a ɛfiri wo mu.Deɛ ɛdi kan yɛ nhoma ne w’akyi nkasɛe a ɛwɔ fam no,ɛna deɛ ɛtwa toɔ no yɛ adwenem nneɛma binom.Sɛ ɛsi saa wɔ ne mmienu mu a, na adwene no ne akyikasɛe hia sɛ ɛbɛma kɔteɛ no asɔre.Adeɛ a ɛma kɔteɛ no ano sɔre tumi ma nsuo bi firi mu ba a wɔfrɛ no nitric oxide(NO),a ɛma corpora cavernosa tumi dwodwo ne ho no( ɛno ne adeɛ titire pa ara a ɛma kɔteɛ no sɔre).Bio, testosterone(deɛ hwoa no de ba no) ne intact pituitary gland hia pa ara ma kɔteɛ no tumi sɔre.

## Nsɔano

Nsɔano no gyina deɛ ɛde ba no so. Ne nyinaa mu no adwuma, ne titire no honam mu adwuma a yɛde tenetene yɛn mpɔ mu no hia pa ara a ɛtumi boa si kɔtewuiɛ ano wɔ yɛn bra mu. Sɛ deɛ ɛde ba no yɛ adwenem haw a, ɛneɛ na kasakyerɛ ho hia, ɛne kwan a wɔfa so te brɛ ne ayamhyehyeɛ a ɛfa ɔbaa ne ɔbarima nhyiamudie ho. Nnuro a wɔde fa wano ne wo kɔte a ɛbɛsɔre kwa no yɛ nsɔano a ɛdi kan, na afei nnuro a wɔde fa paneɛ mu de wɔ kɔteɛ no mu ne adeɛ a wɔpae kɔteɛ no mu de hyɛ mu de sa kɔtewuiɛ no. Pae a wɔpae nipadua no hia ma nnipakuo binom. Ayarehwɛ, kyɛn sɛ wɔbɛpae obi no, ɛnsa adwenem haw, na mmom ɛho hia sɛ wɔyɛ ansa na ɔbaa ne ɔbarima nhyiamudie akɔ so.
 

## Lɛsikɔlɔgyi
Latin asɛmfua *impotentia coeundi* kyerɛ ɔkwan a wontumi mfa kɔteɛ nhyɛ Ɔbaa twɛ mu; seisei no wɔde nsɛmfua pii ahyɛ anan, ɛbi te sɛ Kɔtewuiɛ. Kɔtewuiɛ ho adesua wɔ nnurosɛm mu no fa kɔteɛ apɔmuden ho, a ɛyɛ nkorabata wɔ kɔteɛ adesua ho. Nhwehwɛmu kyerɛ sɛ Kɔtewuiɛ dɔɔso, na wɔasusu sɛ bɛyɛ mmarima mu ɔha mu nkyekyɛmu aduanan(40%) nya kɔtewuiɛ ho  mpopoeɛ,da titire. Wɔfrɛ saa tebea no sɛ *phallic impotence*. Ɛne priapism na ɛbɔ abira.

## Beaɛ A Menyaa Mmoa Firiiɛ