Vascular & Neurologic Abnormalities

Organic Impotence:

Patient Identification: DPA

General Medical Hx
self-employed, single 0 children
age: 50
med.dx :psoriasis.

surgeries:bilateral herniorrhaphies, 1953, 1976
smoker: no
alcohol: 1-2 alcoholic beverages per day x many years
meds: none

Sexual Hx

• bisexual

• difficulty obtaining and maintaining erections since 1983

• gradual onset of sexual dysfunction

• denies decreased penile sensation

• semi-erections noted in A.M. and nocturnal awakenings

• mild improvement with oral sex

• erections are not sufficient for vaginal penetration

• penile curvature: denies

• last successful intercourse: June, 1984

• ejaculation intact

• denies premature ejaculation

• libido: normal

• bladder symptoms: denies

• bowel symptoms: denies

• sleep disturbances: none

Physical Exam

WNL except reduced anal tone

no BCR

BP: not available

Test Results
Glucose, TST, Prolactin, LH—WNL

	Electrophysiological Tests
NCV of DNP	36.10 M/sec/-NI.
PER	41.60 M/sec/-NI.
BCR	29.90 M/sec/-NI.

RigiScan:Abnl. X 3 nights – NI. Tumescence with reduced rigidity at base of penis, abnormal tumescence and reduced rigidity at tip of penis

Final Dx
Organic impotence associated with neuro vascular abnormalities