Psychogenic impotence in spinal cord injury patients

Abstract

Objective: To compare subjective assessments of erectile function with results obtained from nocturnal penile tumescence and rigidity (NPTR) monitoring in patients with spinal cord injury (SCI) Design: A prospective study. Setting: Erectile function questionnaires were completed by cach patient. NPTR monitoring was performed at the patient's home with The Rigisca system. Patients: Thirty SCI patients (8 cervical, 16 thoracic, 5 lumbar, 1 sacral) were between 22 and 75 (mean 48) years old. Twenty patients (67%) had complete SCI and 10 patients (33%) had incomplete SCI with mean duration since injury of 14 years. Main Outcome Measures: The results from 2 consecutive nights of NPTR monitoring were compared with each patient's own response to our erectile function questionnaire. Results: Twenty-three patients (77%) reported normal erectile function: 16 had normal NPTR studies and the remaining 7 had abnormal NPTR studies. Seven patients (23%) reported poor-to-absent erectile function: 3 had normal NPTR studies and 4 hd abnormal NPTR studies. All 10 patients (100%) with incomplete SCI had NPTR studies that corroborated their own assessment of erectile function, compared to 11 to 20 patients (55%) with complete SCI. NPTR studies in the remaining 9 patients (45%) with complete SCI were inconsistent with their own assessment of erectile function. Conclusions: A direct correlation ( p < .05) existed between incomplete SCI patients' NPTR studies and their own assessment of erectile function. Complete SCI patients demonstrated significant discrepancy between their own assssments of erectile function and results from NPTR studies. Incomplete SCI patients tended to maintain normal erectile function, as opposed to complete SCI patients. Ten percent of SCI patients who reported erectile dysfunction may actually be suffering from psychogenic impotence.