Evaluation of the impotent male
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Evaluation of the impotent male. Zafar Khan, MD. Beth Israel Medical Center, NYC. Evaluation of the impotent male. Medical and Psychosexual history. Physical examination: Nocturnal penile tumescence. Neurologic testing. Sacral Evoked response. Genitocerebral Evoked response.

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Evaluation of the impotent male l.jpg

Evaluation of the impotent male.

Zafar Khan, MD

Beth Israel Medical Center, NYC.


Evaluation of the impotent male3 l.jpg
Evaluation of the impotent male.

  • Medical and Psychosexual history.

  • Physical examination:

    • Nocturnal penile tumescence.

    • Neurologic testing.

      • Sacral Evoked response.

      • Genitocerebral Evoked response.

  • Hormonal Testing.


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Evaluation of the impotent male.

  • Nocturnal penile tumescence testing (NPT):

    • To distinguish psycogenic from organic causes.

    • NPT occurs during REM sleep, 4 to 5 erectile episodes per night, lasting longer than 30 min.

    • Increase of circumference greater than 3cm.

    • Increase of rigidity 70% of maximal.


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Evaluation of the impotent male.

  • Vascular Evaluation:

    • Pulsed Doppler analysis.

    • Duplex-Ultrasonography.

  • Arteriography.

  • Cavernosometry / Cavernosography.


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Evaluation of the impotent male.

  • Cavernosometry:

    • Injection of 10g PGE1.

    • Intracorporal pressure measurement (120mm Hg).

    • Corporal infusion (maintainance 5ml/min).

    • Pressure decay (< 45mm/Hg in 30 sec).

  • Cavernosography:

    • Infusion of contrast medium.


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Evaluation of the impotent male.

  • Neurological testing:

    • Biothesiometry:

      • Sensory perception of vibratory stimulation.

    • Sacral evoked response (BC reflex latency).

      • 30-40 mil/sec at 50 volts.

    • Genitocerebral evoked potential studies:

      • Cerebral response to dorsal penile nerve stimulation.


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Evaluation of the impotent male.

ZAFAR KHAN, M.D.

Phone: 212-420-1566

www.aboutsexualdysfunctions.com

www.urologyandyou.com

E-Mail: [email protected]


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