Impotence: Are the Newer Diagnostic Methods a Necessity?

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Abstract
Impotent patients (33) were evaluated and compared the results of the laboratory methods to the initial diagnoses of the psychiatrist and the urologist to determine if the new methods would confirm initial impressions or uncover different diagnoses. Thirteen patients were considered to have psychogenic impotence by the clinicians and only 1 patient in this group had evidence of organicity when the laboratory tests were used. Twelve patients were considered to have organic impotence by the clinicians which was confirmed in 75% of the cases by laboratory testing. Thus, clinical evaluation predicted the outcome of laboratory methods in 92% of the psychogenic group and 75% of the organic group. Postage stamps were used during nocturnal penile tumescence monitoring and in predicting the outcome of nocturnal tumescence monitoring the stamp test had a sensitivity and a specificity of 91%. Many patients presenting with erectile impotence can be evaluated adequately by a psychiatrist and a urologist without the support of expensive laboratory tests. The postage stamp test is useful when nocturnal penile tumescence monitors are not available. The Minnesota Multiphasic Personality Inventory is of limited value as a screening device.