Evaluation of Erectile Dysfunction

  • Cynthia G. Kreger
  • Jeffrey P. York
Part of the Contemporary Internal Medicine book series (COIM, volume 3)


A 68-year-old male was seen in the ambulatory setting at the Ohio State University Hospitals, for general medical evaluation after his primary care provider had retired. He had long-standing Type II diabetes mellitus managed with insulin and an oral agent. He also had moderate systolic hypertension treated with a diuretic and beta blocker. Although he denied any known cardiovascular disease, evaluation of his resting EKG revealed evidence of an inferior myocardial infarction.


Erectile Dysfunction Penile Erection Penile Prosthesis Nocturnal Penile Tumescence Intracavernosal Injection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Shabsigh R, Fishman IJ, Scott FB: Evaluation of erectile impotence. Urology. 1988;32:83–90.PubMedCrossRefGoogle Scholar
  2. 2.
    Furlow WL: Prevalence of impotence in the United States. Med Aspects Hum Sex. 1985;19:13–16.Google Scholar
  3. 3.
    Kinsey AC, Pomerroy WB, Martin CE: Sexual behavior in the human male. Philadelphia, WB Saunders Co, 1948.Google Scholar
  4. 4.
    Slag MF, Morley JE, Elson MK, et al: Impotence in medical clinic outpatients. JAMA. 1983;249:1736–1740.PubMedCrossRefGoogle Scholar
  5. 5.
    Kaiser FE, Korenman SG: Impotence in diabetic men. Am J Med. 1988;85:147–152.PubMedCrossRefGoogle Scholar
  6. 6.
    Saenz de Tejada I, Goldstein I: Diabetic penile neuropathy. Urol Clin North Am. 1988;15:17–22.PubMedGoogle Scholar
  7. 7.
    Morely JB: Impotence. Am J Med. 1986;80:897–905.CrossRefGoogle Scholar
  8. 8.
    Malloy TR, Markowicz KB: Pharmacologic treatment of impotence. Urol Clin North Am. 1987;14:297–305.PubMedGoogle Scholar
  9. 9.
    Aboseif SR, Lue TF: Hemodynamics of penile erection. Urol Clin North Am. 1988;15: 1–7.PubMedGoogle Scholar
  10. 10.
    Fournier GR, Juenemann KP, Lue TF, et al: Mechanisms of venous occlusion during canine penile erection: An anatomic demonstration. J Urol. 1987;137:163–167.PubMedGoogle Scholar
  11. 11.
    Saenz de Tejada I, Goldstein I, Azadzoi K, et al: Impaired neurogenic and endothelium-mediated relaxation of penile smooth muscle from diabetic men with impotence. NEJM. 1989;320:1025–1030.PubMedCrossRefGoogle Scholar
  12. 12.
    Saenz de Tejada I, Goldstein I, Krane RJ: Local control of penile erection. Urol Clin North Am. 1988;15:9–15.PubMedGoogle Scholar
  13. 13.
    Montague DK, James RE, de Wolfe VG, et al: Diagnostic evaluation, classification and treatment of men with sexual dysfunction. Urology. 1979;14:545–549.PubMedCrossRefGoogle Scholar
  14. 14.
    Maatman TJ, Montague DK, Martin LM: Erectile dysfunction in men with diabetes mellitus. Urology. 1987;24:589–592.CrossRefGoogle Scholar
  15. 15.
    Jevtich MJ, Khawand NY, Vidic B: Clinical significance of ultrastructural findings in the corpora cavernosa of normal and impotent men. J Urol. 1990;143:289–293.PubMedGoogle Scholar
  16. 16.
    McClure RD: Endocrine evaluation and therapy of erectile dysfunction. Urol Clin North Am. 1988;15:53–63.PubMedGoogle Scholar
  17. 17.
    Virag R, Bouilly P, Frydman D: Is impotence an arterial disorder? A study of arterial risk factors in 440 impotent men. Lancet. 1985;1:182–184.Google Scholar
  18. 18.
    Krane RJ: Sexual function and dysfunction, in Walsh PC, Gittes RF, Perlmutter AD, Stamey TA (eds): Campbell’s Urology. Philadelphia, WB Saunders Co, 1986;vol. 1, pp 700–735.Google Scholar
  19. 19.
    Torrens MJ: Neurologic and neurosurgical disorders associated with impotence, in Krane RJ, Siroky MB, Goldstein I (eds): Male Sexual Dysfunction. Boston: Little, Brown, 1983, pp 55–61.Google Scholar
  20. 20.
    Seagraves RT, Madsen R, Carter CS, et al: Erectile dysfunction associated with pharmacologic agents, in Seagraves RT, Schoenberg HW (eds): Diagnosis and Treatment of Erectile Disturbances. New York, Plenum Medical, 1985, pp 23–63.CrossRefGoogle Scholar
  21. 21.
    Wein AJ, Van Arsdalan KN: Drug induced male sexual dysfunction. Urol Clin North Am. 1988;15:23–30.PubMedGoogle Scholar
  22. 22.
    Abel EL: A reveiw of alcohol’s effects on sex and reproduction in drug alcoholic dependency. Drug Alcohol Depend. 1980;5:321–327.PubMedCrossRefGoogle Scholar
  23. 23.
    Rodriques-Blazquez HM, Cardona PE, Rivera-Herrera JL: Priapism associated with the use of topical cocaine. J Urol. 1990;143:358.Google Scholar
  24. 24.
    Forsberg L, Gustavii B, Hojerback T, et al: Impotency, smoking and beta blocking drugs. Fertil Steril. 1979;31:589–594.PubMedGoogle Scholar
  25. 25.
    Barlow DH: Causes of sexual dysfunction: The role of anxiety and cognitive interference. J Consult Clin Psychol. 1986;54:140–148.PubMedCrossRefGoogle Scholar
  26. 26.
    Smith AD: Psychological factors in the multidisciplinary evaluation and treatment of erectile dysfunction. Urol Clin North Am. 1988;15:41–51.PubMedGoogle Scholar
  27. 27.
    Padma-Nathan H, Goldstein I, Krane RJ: Evaluation of the impotent patient. Semin Urol. 1986;4:225–232.PubMedGoogle Scholar
  28. 28.
    Ware JC: Impotence and aging. Clin Geriatr Med. 1989;5:301–314.PubMedGoogle Scholar
  29. 29.
    Karacan I: Clinical value of nocturnal erection in the prognosis and diagnosis of impotence. Med Aspects Human Sex. 1970;4:27–34.Google Scholar
  30. 30.
    Kessler WO: Nocturnal penile tumescence. Urol Clin North Am. 1988;15:81–86.PubMedGoogle Scholar
  31. 31.
    Wein AJ, Fishkin R, Carpiniello VL, et al: Expansion without significant rigidity during nocturnal penile tumescence testing: A potential source of misinterpretation. J Urol. 1981;126:343–344.PubMedGoogle Scholar
  32. 32.
    Barry JM, Blank B, Boileau M: Nocturnal penile tumescence testing with stamps. Urology. 1980;15:171–172.PubMedCrossRefGoogle Scholar
  33. 33.
    Anders EK, Bradley W, Krane RJ: Nocturnal penile rigidity measured by the Snap Gauge band. J Urol. 1983;129:964–966.Google Scholar
  34. 34.
    Karacan I, Moore CA: Nocturnal penile tumescence: An objective diagnostic aide for erectile dysfunction, in Bennett AH (ed): Management of Male Impotency. Baltimore, Williams & Wilkins, 1982, pp 62–72.Google Scholar
  35. 35.
    Gaskell P: The importance of penile blood pressure in cases of impotency. Can Med Assoc 1971;105:1047–1050.Google Scholar
  36. 36.
    Mueller SC, Lue TF: Evaluation of vasculogenic impotence. Urol Clin North Am. 1988;15:65–74.PubMedGoogle Scholar
  37. 37.
    Britt DB, Kemmerer WT, Robison JR: Penile blood flow determination by mercury strain gauge plethysmography. Invest Urol. 1971;8:673–677.PubMedGoogle Scholar
  38. 38.
    Zorgniotti AW: Practical diagnostic screening for impotence. Urology. 1984;23:98–102.PubMedCrossRefGoogle Scholar
  39. 39.
    Melman A: The evaluation of erectile dysfunction. Urol Radioi. 1988;10:119–128.CrossRefGoogle Scholar
  40. 40.
    Virag R: Intracavernous injection of papaverine for erectile failure. Lancet. 1982;2:938.PubMedCrossRefGoogle Scholar
  41. 41.
    Abber JC, Lue TF, Orvis BR, et al: Diagnostic tests for impotence: A comparison of papaverine injection with the penile-brachial index and nocturnal penile tumescence monitoring. J Urol. 1986;135:923–925.PubMedGoogle Scholar
  42. 42.
    Lue TF, Mueller SC, Jow R: Functional evaluation of penile arteries with duplex ultrasound in vasodilator-induced erection. Urol Clin North Am. 1989;16:799–807.PubMedGoogle Scholar
  43. 43.
    Virag R, Frydman D, Legman M, et al: Intracavernous injection of papaverine as a diagnostic and therapeutic method in erectile failure. Angiology. 1984;35:79–87.PubMedCrossRefGoogle Scholar
  44. 44.
    Lue TF, Takamura T, Schmidt RA, et al: Human dynamics of erections in the monkey. J Urol. 1983;130:1237–1241.PubMedGoogle Scholar
  45. 45.
    Lue TF, Hricak H, Schmidt RA, et al: Functional evaluation of penile veins by cavernosography in papaverine-induced erection. J Urol. 1986;135:479–482.PubMedGoogle Scholar
  46. 46.
    Steif CG, Wetterauer U: Quantitative and qualitative analysis of dynamic cavernosographies in erectile dysfunction due to venous leakage. Urology. 1989;34:252–257.CrossRefGoogle Scholar
  47. 47.
    Goldstein I, Krane RJ, Greenfield AJ, et al: Vascular diseases of the penis: Impotence and priapism, in Pollack HM (ed): Clinical Urography. Philadelphia, WB Saunders Co, 1990, vol 3, pp 2231-2247.Google Scholar
  48. 48.
    Padma-Nathan H: Neurologic evaluation of erectile dysfunction. Urol Clin North Am. 1988;15:77–80.PubMedGoogle Scholar
  49. 49.
    Morales A, Condra M, Owen JA, et al: Is yohimbine effective in the treatment of organic impotence? Results of a controlled trial. J Urol. 1987;137:1168–1172.PubMedGoogle Scholar
  50. 50.
    Orvis BR, Lue TF: New therapy for impotence. Urol Clin North Am. 1987;14:569–581.PubMedGoogle Scholar
  51. 51.
    Zorgniotti AW, Lefleur RS: Auto-injection of the corpus cavernosum with a vasoactive drug combination for vasculogenic impotence. J Urol. 1985;133:39–41.PubMedGoogle Scholar
  52. 52.
    Sidi AA: Vasoactive intracavernous pharmacotherapy. Urol Clin North Am. 1988;15:95–101.PubMedGoogle Scholar
  53. 53.
    Lewis RW: Venous surgery for impotence. Urol Clin North Am. 1988;15:115–121.PubMedGoogle Scholar
  54. 54.
    Treiber U, Gilbert P: Venous surgery in erectile dysfunction: A critical report on 116 patients. Urology. 1989;34:22–27.PubMedCrossRefGoogle Scholar
  55. 55.
    Bretan PN: History of the prosthetic treatment of impotence. Urol Clin North Am. 1989;16:1–6.PubMedGoogle Scholar
  56. 56.
    Montague DK: Penile prosthesis: An overview. Urol Clin North Am. 1989;16:7–11.PubMedGoogle Scholar
  57. 57.
    Witherington R: Suction device therapy in the management of erectile impotence. Urol Clin North Am. 1988;15:123–127.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1991

Authors and Affiliations

  • Cynthia G. Kreger
  • Jeffrey P. York

There are no affiliations available

Personalised recommendations