Psychogenic versus primary organic impotence.

The origin of impotence in unmarried patients is believed to be mostly psychogenic and has been diagnosed as such. However, we occasionally found that some of these patients showed clinical findings strongly suggesting an organic cause. We investigated the clinical spectrums of 160 unmarried impotent patients (145 psychogenic impotent patients and 15 primary organic impotent patients). The primary organic impotent patients had a history of unsuccessful sustained erections and intercourse without any trauma or definite associated medical disease, and showed abnormal findings in the audiovisual stimulation penogram (AVS-penogram), whereas only 66% (96/145) of the psychogenic group showed abnormal classification. The most common cause of primary organic impotence was vasculogenic. Primary organic impotence should be considered a specific disease for which comprehensive diagnostic methods are needed in unmarried impotent patients to differentiate it from psychogenic impotence.