Diagnosis and therapy of organic impotence

Abstract

A stepwise diagnosis using objective and reproducible methods of examination makes it possible to distinguish between psychogenic and organic causes of impotence. Among 104 men who had organic disorders of erection half were due to local penile disease, the remainder to vascular disease (diabetic angiopathy, arteriosclerosis, abnormal venous drainage). Cavernosal through-flow measurements revealed differences among the various groups of disorders with regard to the flow rates required for achieving and maintaining an artificial erection and made it possible, in conjunction with other tests (Doppler perfusion measurements and papaverine response), to arrive at a precise diagnosis and plan for surgical intervention. Of 91 men who had been operated upon 79 had good results (87%). Largely noninvasive diagnostic measures thus achieved effective treatment and thus contributed to an improved feeling of self-esteem.