Penile Vascular Etiology of Primary Impotence

Abstract

The etiology of primary impotence has long been considered to be mostly psychogenic. On the basis of their study of 400 impotent men, the authors found conversely that a subgroup of 24 patients (6%) with primary erectile dysfunc tion had an organic etiology responsible for the disorder. Of these, 20 (83.3%) were found to have penile arterial insufficiency, either alone or associated with hormonal or neural deficiencies; the remaining 4 patients had hormonal defi ciencies alone. Detected lesions of the penile arteries were subtle and mostly congenital. The authors recommend that a complete urologic and vascular work-up be performed prior to attempting a lengthy psychosexual therapy, be cause modern urologic and vascular therapy does offer definite cure to these patients.