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Vascular & Neurologic Abnormalities


Organic Impotence:

Vascular & Neurologic Abnormalities

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

Doppler  Pre-Exercise Post-Exercise
Rt. .96 – NI.  .57–Abnl.
Lt. .1.0 - NI. .82 – NI.
Mid .93 – Borderline Abnl. .71 – Borderline Abnl.



  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