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Vascular Abnormalities


Organic Impotence:

Vascular Abnormalities

General Medical Hx
retired widower, 6 children
age: 61 med.dx : HTN, diagnosed 1975 spinal arthritis
surgeries: C5, C6 disk, 1967 C4, C5 disk, 1970
smoker: no
alcohol: 6 oz. wine/day x many years
meds: Hygroton, 25my. q. d.


Sexual Hx
• difficulty obtaining and maintaining erections since 1975

• complain of penile numbness

• gradual onset of sexual dysfunction

• occasional A.M. erections, denies nocturnal erections

• slight improvement of erection with masturbation and in supine position upon awakening

• penile curvature: denies

• last successful intercourse: 1979-1980

• ejaculation intact – masturbation

• premature ejaculation: denies

• libido: normal

• bladder symptoms: denies

• bowel symptoms: denies

• sleep disturbances: considers himself a restless sleeper ( arthritic pain awakens him 3-4 times/night)


Physical Exam
WNL except it. Kidney palpated
BP: 170/80


Test Results
Glucose, TST—WNL


Doppler  Pre-Exercise Post-Exercise
Rt. .80 – NI.  .71 – Borderline Abnl.
Lt. .79 - NI. .70 – Borderline Abnl.
Mid .73 – Borderline Abnl. .55 – Abnl.



  Electrophysiological Tests
NCV of DNP 42 M/sec/-NI.
PER not ordered
BCR not ordered


RigiScan: Abnl. X 3 nights – DISSOCIATION (distal penile shaft softening)




Final Dx
Organic impotence associated with vascular insufficiency