Evaluation of the impotent male. Zafar Khan, MD Beth Israel Medical Center, NYC.

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Presentation transcript:

Evaluation of the impotent male. Zafar Khan, MD Beth Israel Medical Center, NYC.

Evaluation of the impotent male. Medical and Psychosexual history. Physical examination: –Nocturnal penile tumescence. –Neurologic testing. Sacral Evoked response. Genitocerebral Evoked response. Hormonal Testing.

Evaluation of the impotent male. Nocturnal penile tumescence testing (NPT): –To distinguish psycogenic from organic causes. –NPT occurs during REM sleep, 4 to 5 erectile episodes per night, lasting longer than 30 min. –Increase of circumference greater than 3cm. –Increase of rigidity 70% of maximal.

Evaluation of the impotent male. Vascular Evaluation: –Pulsed Doppler analysis. –Duplex-Ultrasonography. Arteriography. Cavernosometry / Cavernosography.

Evaluation of the impotent male. Cavernosometry: –Injection of 10  g PGE1. –Intracorporal pressure measurement (120mm Hg). –Corporal infusion (maintainance 5ml/min). –Pressure decay (< 45mm/Hg in 30 sec). Cavernosography: –Infusion of contrast medium.

Evaluation of the impotent male. Neurological testing: –Biothesiometry: Sensory perception of vibratory stimulation. –Sacral evoked response (BC reflex latency) mil/sec at 50 volts. –Genitocerebral evoked potential studies: Cerebral response to dorsal penile nerve stimulation.

Evaluation of the impotent male. ZAFAR KHAN, M.D. Phone: