Evaluation of the First 70 Patients in the Center for Male Sexual Dysfunction of Beth Israel Medical Center

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Abstract
Patients (70) were evaluated for male sexual dysfunction. The results of the analysis demonstrated that 55% had organic impairment. There was mild elevation of serum prolactin in 6 cases, none of which was the direct cause of the impotence. A total of 15 patients had a diagnosis of either impaired glucose tolerance or overt diabetes (7 with organic and 8 with psychogenic disease). Therefore, the diagnosis of diabetes or impaired glucose tolerance, whether known previously or not, should not be accepted as confirming the organicity of impotence. Nocturnal penile tumescence alone confirmed the diagnosis or psychogenic impotence only when a rigid erection 5 min in duration occurred. The absence of nocturnal erections cannot be interpreted as conclusive evidence of organic impotence. A definitive diagnosis of psychogenic impotence was made based only on visual sexual stimulation 6 patients. Etiologic factors of organic or psychogenic impotence are complex and a multidisciplinary approach should be used.