Evaluation of the impotent male.
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Evaluation of the impotent male. Zafar Khan, MD Beth Israel Medical Center, NYC.
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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. - PowerPoint PPT Presentation
Transcript of Evaluation of the impotent male.
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.
• Hormonal Testing.
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.
Evaluation of the impotent male.
• Vascular Evaluation:– Pulsed Doppler analysis.– Duplex-Ultrasonography.
• Arteriography.
• Cavernosometry / Cavernosography.
Evaluation of the impotent male.
• Cavernosometry:– Injection of 10g PGE1.– Intracorporal pressure measurement (120mm
Hg).– Corporal infusion (maintainance 5ml/min).– Pressure decay (< 45mm/Hg in 30 sec).
• Cavernosography:– Infusion of contrast medium.
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.
Evaluation of the impotent male.
ZAFAR KHAN, M.D.Phone: 212-420-1566
www.aboutsexualdysfunctions.comwww.urologyandyou.comE-Mail: [email protected]
