Melman A, Kaplan D, Redfield J
J Urol. 1984 Jan;131(1):53-5. doi: 10.1016/s0022-5347(17)50198-6.
We evaluated 70 patients for male sexual dysfunction in our center during its first 6 months of operation. The results of the analysis demonstrated that 55 per cent had organic impairment. Several important findings should be emphasized. 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. Also, nocturnal penile tumescence alone confirmed the diagnosis of psychogenic impotence only when a rigid erection 5 minutes in duration occurred. The absence of nocturnal erections cannot be interpreted as conclusive evidence of organic impotence. Finally, a definitive diagnosis of psychogenic impotence was made based only on visual sexual stimulation in 6 patients. Our results emphasize further that etiologic factors of organic or psychogenic impotence are complex and that a multidisciplinary approach should be used.
在我们中心运营的前6个月，我们对70例男性性功能障碍患者进行了评估。分析结果显示，55%的患者存在器质性损伤。有几个重要发现需要强调。6例患者血清催乳素轻度升高，但均不是阳痿的直接原因。共有15例患者被诊断为糖耐量受损或显性糖尿病（7例为器质性疾病，8例为心因性疾病）。因此，无论之前是否已知，糖尿病或糖耐量受损的诊断都不能被视为确定阳痿的器质性病因。此外，仅当夜间阴茎勃起持续5分钟时，夜间阴茎胀大才能确诊为心因性阳痿。夜间勃起缺失不能被解释为器质性阳痿的确凿证据。最后，仅基于视觉性刺激对6例患者做出了心因性阳痿的明确诊断。我们的结果进一步强调，器质性或心因性阳痿的病因很复杂，应采用多学科方法。
