Evaluation of the impotent male Zafar Khan MD

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 3 cm. – 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 10 g PGE 1. – Intracorporal pressure measurement (120 mm Hg). – Corporal infusion (maintainance 5 ml/min). – Pressure decay (< 45 mm/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. com www. urologyandyou. com E-Mail: zafarkhan@urologyandyou. com