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Neurologic Abnormalities


Organic Impotence:

Neurologic Abnormalities

Patient Identification: LTM

General Medical Hx
technical writer, single, 0 children
age: 33
med.dx :none at the time of this evaluation, however based on the test results of this evaluation AODM has been confirmed.

surgeries: Knee 1970
smoker: no
alcohol: none
meds: none


Sexual Hx
• difficulty obtaining and maintaining erections since 1981

• complains of decreased penile sensation

•   denies A.M. and nocturnal erections

•   no improvement with other forms of sexual stimuli

•   erections are never sufficient for vaginal penetration

•   no improvement in erections with position changes

•   penile curvature: denies

•   last successful intercourse: 1981-1982

•   ejaculation intact – oral sex and masturbation, but sometimes difficult

•   premature ejaculation: denies

•   libido: normal

•   has noted difficulty maintaining relationships secondary to erectile dysfunction

•   bladder symptoms: difficulty starting stream 70% of time

•   bowel symptoms: diarrhea

•   sleep disturbances: none


Physical Exam
essentially WNL
BP: not available


Test Results


Doppler  Pre-Exercise Post-Exercise
Rt. .91 – NI.  .64 –Abnl.
Lt. .86 - NI. .85 – Abnl.
Mid .84 – Borderline Abnl. .79 – Abnl.



  Electrophysiological Tests
NCV of DNP 39.8 M/sec/-NI.
PER 43.26 M/sec/-NI.
BCR 45.34 M/sec/-NI.


RigiScan:Abnl. X 3 nights – NI. Tumescence of base and tip (even though rigidity was noted in the 50-70% range, it occurred alternately at the base and tip of the penile shaft during different events)




Final Dx
Organic impotence associated with neurological abnormalities