Snap Gauge bands were applied to measure nocturnal penile rigidity in the impotent patients and the results were compared with PBI and findings of the papaverine induced artificial erection. The results were as follows: 1. The results of Snap Gauge test were relatively competitive with the degree of erectile dysfunction which organic impotent patients complained of. 2. PBI less than 0.85 implied insufficient rigidity and PBI over 0.95 showed sufficient rigidity in Snap Gauge tests. 3. The possibility of "false positive" or "false normal" in diagnosis of the impotence was higher in the papaverine induced artificial erection tests than in the Snap Gauge tests. Conclusively, Snap Gauge band is simple to use and effective to measure quantitatively the penile rigidity reached during nocturnal erections in impotent patients.
Diagnosis* ; Erectile Dysfunction* ; Humans ; Male ; Papaverine

To clarify the correlation between erotic and nocturnal erection and evaluate their diagnostic efficacy in impotence, a comparative study was done with audiovisual stimulation penogram (AVS-Penogram) and nocturnal penile erection monitoring (NPEM: RigiScan) in two hundred twenty two impotent patients. The compatibility ratios of the audiovisual stimulation penogram and nocturnal penile erection monitoring were 74.2% in Type I (normal findings) and 66.6% in Type IIA penogram (unresponsive type). The ratio of type IIB (fluctuation type) was 37.9%. much lower compared to that of Type I. Based on the final diagnosis, audiovisua1 stimulation penogram-only had high compatibility ratio with psychogenic origin for Type I (77.7%) and with organic impotence for Type IIA (80%). Moreover combined audiovisual stimulation penogram and nocturnal penile erection monitoring had higher compatibility ratio (86.2%) than that of audiovisual stimulation penogram only analysis (77.7%) with psychogenic impotence. Therefore, we suggest that audiovisual stimulation penogram is an accurate method in Type I and Type IIA. Furthermore combined interpretation of audiovisual stimulation penogram and nocturnal penile erection monitoring may produce more precise diagnosis, especially in psychogenic impotence.
Diagnosis ; Erectile Dysfunction ; Humans ; Male ; Penile Erection*

No abstract available.
Diagnosis* ; Erectile Dysfunction* ; Humans ; Male ; Outpatients*

A variety of technique of dynamic pharmacocavernosometry have been described to evaluate cavernous veno-occlusive function: however, there is no uniquely reliable and standard method so far After intracavernous (IC) injection of 45 mg papaverine and 2.5 mg phenblamine, we performed gravity cavernosometry(GC) and pump cavernosometry(PC), ie, measurement of saline infusion rate needed to obtain and to maintain an erection and measurement of pressure decay for 30 seconds and pressure drop time to 75 mmHg when pump was turned off at 150 mmHg IC pressure. Final diagnosis of venous leakage was made by cavernosoeraphy done at 90 mmHg IC pressure. The parametric values measured by each method to diagnose venous leakage and correlation among these methods were analyzed. The etiology of impotence in 45 patients studied was psychogenic in 8, venogenic in 21, combined arteriogenic and venogenic in 16. The measurement of induction flow rate was less reliable(p<0.05) for the diagnosis of venous leak than the other methods of PC and GC (p<0.01). The standard deviations of the induction and maintenance flow rate and pressure drop time were similar to or even higher than mean values. There was correlation among all these methods. Therefore, GC and PC, particularly measurement of the intracorporeal pressure decay are believed to be valuable methods for diagnosis of the corporal-venous leakage.
Diagnosis ; Erectile Dysfunction ; Gravitation ; Humans ; Male ; Papaverine

Erectile dysfunction (ED) is a major sexual dysfunction involving both physiological and psychological factors. While the primary physiological cause of ED is associated with endocellular degeneration and disorders of neural reflex, its psychological causes are mainly hyposexuality, anxiety and depression. Increasing importance is being attached to the psychological aspects in the diagnosis and management of ED in recent years, and the evaluation questionnaires aimed at the psychosocial significance in ED patients' conditions and psychological interventions solo or combined with drugs have inspired many researches for an optimal solution of the disease. Improvement of the patient's erectile performance is no longer the only outcome we pursue. Instead, the satisfaction of both the patient and his partner has a rising weight in the final evaluation of a therapy. The wide application of PED5 inhibitors and their psychological effect on ED patients makes it necessary for us gain a deeper insight into the combination of psychological intervention and drug therapy in the management of ED.
Erectile Dysfunction ; diagnosis ; psychology ; therapy ; Humans ; Male

We performed erotic stimulation that in 63 patients with erectile dysfunction in order to investigate erectile responses to visual sexual stimulation in patients with psychogenic and organic impotence and to elucidate valuable parameters for differential diagnosis between psychogenic and organic impotence. After the test using polygraph system and erotic film, subjective sexual drive in each patient was evaluated as grade I (poor), grade II (moderate), grade III (good). Following parameters were statistically analyzed : degree of maximal rigidity, degree of maximal tumescence, T -up phase (time taking place from the beginning of the erection to maximal level). The T-max phase (time taking place for the plateau phase of maximal erection). The results obtained were summarized as follows. Regardless of sexual drive of each patient, psychogenic impotence group showed better maximal rigidity and shorter T-up phase of rigidity than organic impotence group (p<0.05}. Of patients with psychogenic impotence, good sexual drive group showed better maximal rigidity and maximal tumescence than poor sexual drive group (p<0.06). Psychogenic impotence group showing good sexual drive revealed much better maximal rigidity and shorter T-up phase of rigidity than organic impotence group with same degree of sexual drive (p<0.05). These results indicate erotic stimulation test is highly valuable method for differential diagnosis between psychogenic and organic impotence, especially when the patient shows sexual drive in moderate or good degree. And it is suggested that maximal rigidigity and T-up phase of erection parameters in erotic stimulation test provide high validity for the differention.
Diagnosis, Differential ; Erectile Dysfunction* ; Humans ; Male

Sexual dysfunction is common among male adults. Here we summarized the recent papers and provided the outline of diagnosis and treatment on male sexual dysfunction.
Adult ; Erectile Dysfunction ; diagnosis ; therapy ; Humans ; Male

PURPOSE: This study evaluated the diagnostic utility of a 3-Dimensional head mounted display(HMD) in audiovisual sexual stimulation(AVSS). MATERIALS AND METHODS: A total of 45 men were included in this study: 15 healthy, 15 patients diagnosed with organic impotence, and 15 patients with psychogenic impotence. The NEVA(Nocturnal Electrobioimpedance Volumetric Assessment) system was performed during AVSS with both the 3-D HMD and a conventional monitor. In this study, normal erection was defined as a change in penile blood volume of more than 200% over the baseline for more than 5 minutes. After AVSS, each subject rated his sexual drive as grade I(poor), II(moderate), or III (good). RESULTS: Use of the conventional monitor produced a normal state in 8 men: 5 healthy volunteers(33%) and 3 patients with psychogenic impotence(20%). Use of the 3-D HMD produced a normal state in 23 men: 12 healthy volunteers(80%) and 11 patients with psychogenic impotence(73%). In the healthy volunteers and psychogenic impotence group, the duration of erectile events and percent of volume increase from baseline increased significantly more with 3-D HMD than with the conventional monitor. Compared to results using the conventional monitor, the subjects' sexual drive with 3-D HMD was also significantly increased(p<0.05). CONCLUSIONS: AVSS with 3-D HMD improves the recording of physiological erectile response and may be a valuable tool in making the correct diagnosis of erectile dysfunction.
Blood Volume ; Diagnosis ; Erectile Dysfunction ; Head* ; Healthy Volunteers ; Humans ; Male

Nocturnal penile tumescence is very importent in differential diagnosis between psychogenic and organic impotence. NPT was assessed in 37 impotent patients and 8 normal potent patients. There was no discrepancy between psychogenic and control group, but some 4 case had slight reduced NPT. In all organic cases, the figures of frequency, degree and duration of NPT was significantly reduced. This method is not definite to differentiate impotent: 27% of psychogenic importent patients have reduced NPT. We use some complementary diagnostic tool to diagnose organic impotence: routine lab, snap gauge test, PDI, erection penogram, BCRL and SEP, hormonal test and MMPI etc. This method is useful to differentiate impotence, when used with other complementary method. It is promising, but further study is needed.
Diagnosis, Differential* ; Erectile Dysfunction* ; Humans ; Male ; MMPI ; Penile Erection*

Duplex ultrasonography (USG) is an accepted method to assess noninvasively arterial inflow to the penis. Optimal pharmacological agents as well as timing of the scan and stimulation during the scan continue to be debated. Between August 1994 and May 1996, 24 normal males (control group) and 45 impotent patients (impotence group) underwent penile doppler sonography, and their records were reviewed. Scans were performed at 1, 3, 5, 10, 15, 20 and 30 minutes after intracavernous injection of PGE1 (10 pg) in all subjects. Any subject not having a full erection at 15 minutes performed private self-stimulation for at least 5 minutes before the 30 minute scan. If we define normal arterial inflow as a peak systolic velocity (PSV) of 30 cm. per second or greater in the best artery, 46% of control group and 55% of impotence group achieved this velocity until 5 minutes. One (4%) of control group and three (6%) of impotence group achieved maximum velocity at 1 or 3 minutes but continually PSV of 30 cm. per second or greater after 5 minutes, so any subject may not have had an incorrect diagnosis. When we calculated maximum velocity in the best artery in relation to percentage tumescence, maximum velocity were recorded most often at 10% tumescence (46% of control group and 51% of impotence group). If we define normal arterial inflow as PSV of 30 cm. per second or greater in best artery, the cumulative percentage of patients who achieved this velocity at 1, 3, 5, 10, 15, 20 and 30 minutes were 4, 34, 46, 88, 96, 96 and 100% in control group and 6, 28, 55, 90, 92, 94 and 96% in impotence group. In conclusion, we support delaying the initial scan until 5 minutes, performing the additional scans until 30 minutes and self-stimulation when necessary. We believe all efforts should be made to have studies performed in the setting of least anxiety to the patient.
Alprostadil* ; Anxiety ; Arteries ; Diagnosis ; Erectile Dysfunction ; Humans ; Male ; Penis ; Ultrasonography*