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Evaluation of the impotent male.

Evaluation of the impotent male. Zafar Khan, MD. Beth Israel Medical Center, NYC. Evaluation of the impotent male. Medical and Psychosexual history. Physical examination: Nocturnal penile tumescence. Neurologic testing. Sacral Evoked response. Genitocerebral Evoked response.

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Evaluation of the impotent male.

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  1. Evaluation of the impotent male. Zafar Khan, MD Beth Israel Medical Center, NYC.

  2. Evaluation of the impotent male. • Medical and Psychosexual history. • Physical examination: • Nocturnal penile tumescence. • Neurologic testing. • Sacral Evoked response. • Genitocerebral Evoked response. • Hormonal Testing.

  3. Evaluation of the impotent male. • Nocturnal penile tumescence testing (NPT): • To distinguish psycogenic from organic causes. • NPT occurs during REM sleep, 4 to 5 erectile episodes per night, lasting longer than 30 min. • Increase of circumference greater than 3cm. • Increase of rigidity 70% of maximal.

  4. Evaluation of the impotent male. • Vascular Evaluation: • Pulsed Doppler analysis. • Duplex-Ultrasonography. • Arteriography. • Cavernosometry / Cavernosography.

  5. Evaluation of the impotent male. • Cavernosometry: • Injection of 10g PGE1. • Intracorporal pressure measurement (120mm Hg). • Corporal infusion (maintainance 5ml/min). • Pressure decay (< 45mm/Hg in 30 sec). • Cavernosography: • Infusion of contrast medium.

  6. Evaluation of the impotent male. • Neurological testing: • Biothesiometry: • Sensory perception of vibratory stimulation. • Sacral evoked response (BC reflex latency). • 30-40 mil/sec at 50 volts. • Genitocerebral evoked potential studies: • Cerebral response to dorsal penile nerve stimulation.

  7. Evaluation of the impotent male. ZAFAR KHAN, M.D. Phone: 212-420-1566 www.aboutsexualdysfunctions.com www.urologyandyou.com E-Mail: zafarkhan@urologyandyou.com

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