In-Hospital Nocturnal Penile Tumescence (NPT) Monitoring and Penile-Rigidity Determination in the Differential Diagnosis of Erectile Dysfunction

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Abstract
Penile erections occurring consistently during rapid eye movement (REM) sleep have been documented in healthy males between 3 and 79 but probably occur throughout life. Two mercury-filled strain-gauges on the proximal and distal shaft of the penis accurately detect changes in penile circumference. These changes, recorded in a sleep laboratory concomitantly with other physiological parameters, allow evaluation of the stage and normality of sleep. During an episode of maximum tumescence, penile rigidity was evaluated in 62 subjects by a rigidometer. To date, our findings indicate that penile rigidity of less than 100 mm Hg predicts insufficient firmness for vaginal penetration. Nocturnal penile tumescence (NPT) monitoring is the most objective way to differentially diagnose erectile dysfunction. When solely psychogenic in etiology, NPT and penile rigidity are normal for age; when organic, one or both parameters is decreased.

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