We attempted to identify the etiology of erectile dysfunction in 50 male patients with a mean age of 31.4 (25–42) years. The physical and neurological examinations, history, biochemistry and serum testosterone and prolactin levels were within normal limits. Pharmacopenile duplex ultrasonography, corpus cavernosum electromyography (CC-EMG) and cavernosometry were performed. Smooth muscle tone and the relaxation response after intracavernous papaverine and sodium nitroprusside injections were evaluated by CC-EMG. Autonomic dysfunction has been defined as increased electrical activities after visual sexual stimulation and lowered amplitudes despite normal smooth muscle content. Our definition is similar to this: paradoxically increased electrical activities after intracavernous injection. Caverno-occlusive dysfunction (COD) and accompanying pathologies were found in 38 patients (76%) with pure COD in 26 (52%), COD and arterial pathology in 2 (4%) and COD + autonomic dysfunction in 10 patients (20%). Amplitudes of cavernous electrical activity were low in 32 of 38 patients with COD. These high COD and autonomic dysfunction rates led us to examine these pathologies on molecular and electrophysiological bases.

Keywords:
Impotence, Papaverine, Nitroprusside, Corpus cavernosum, Electromyography
1.
Martin CE: Factors affecting sexual functioning in 60- to 79-year-old males. Arch Sex Behav 1981;10:399–420.
2.
Mulligan T, Katz PG: Why aged men become impotent. Arch Intern Med 1988;149:1365–1366.
3.
Shabsigh R, Fishman IJ, Schum C, Dunn JK: Cigarette smoking and other vascular risk factors in vasculogenic impotence. Urology 1991;38:227–231.
4.
Lerner SE, Melman A, Christ GJ: A review of erectile dysfunction: New insights and more questions. J Urol 1993;149:1246–1255.
5.
Wespes E, Schulman C: Venous impotence. Pathophysiology, diagnosis and treatment. J Urol 1993;149:1238–1245.
6.
Taub H, Melman A, Christ GJ: The relationship between contraction and relaxation in human corpus cavernosum smooth muscle. Urology 1993;42:698–704.
7.
Nehra A, Goldstein I, Pabby A, Nugent M, Huang YH, De las Morenas A, Krane RJ, Udelson D, Saenz de Tejada I, Moreland RB: Mechanisms of venous leakage: A prospective clinicopathological correlation of corporeal function and structure. J Urol 1996;156:1320–1329.
8.
Gerstenberg TC, Nordling J, Hald T, Wagner G: Standardized evaluation of erectile dysfunction in 95 consecutive patients. J Urol 1989;141:857–862.
9.
Wagner G, Gerstenberg TC, Levin RJ: Electrical activity of corpus cavernosum during flaccidity and erection of the human penis. A new diagnostic method. J Urol 1989;142:723–725.
10.
Scheepe JR, Jünemann CP, Bühre CP, Schmidt P, Wiphler G, Berle B, Alken P: Recording the corpus cavernosum electromyogram principles and problems. J Urol 1996;155:2074–2079.
11.
Fabra M, Frieling A, Porst H, Schneider E: Single potential analysis of corpus cavernosum electromyography for the assessment of erectile dysfunction. Provacation, reproducibility and age dependence. Findings in 36 healthy volunteers and 324 patients. J Urol 1997;158:444–450.
12.
Kayıgil Ö, Atahan Ö, Metin A: Electrical activity of the corpus cavernosum in patients with corporal veno-occlusive dysfunction. Br J Urol 1996;77:261–265.
13.
Kayıgil Ö, Atahan Ö, Metin A: Electromyographic changes of corpus cavernosum due to papaverine and nitropusside in veno-occlusive dysfunction. J Urol 1996;156:1316–1319.
14.
Stief CG, Höppner C, Saurwein D, Jonas U: Single potential analysis of cavernous electrical activity in spinal cord injury patients. J Urol 1994;151:367–372.
15.
Kayıgil Ö, Atahan Ö, Metin A: Dynamic infusion cavernosometry and cavernosography in diagnosing and classifying veno-occlusive dysfunction. Int Urol Nephrol 1995;27:615–620.
16.
Krane RJ, Goldstein I, Saenz de Tejada I: Impotence. N Engl J Med 1989;321:1648–1659.
17.
Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB: Impotence and its medical and psychosocial correlates: Results of the Massachusetts male aging study. J Urol 1994;151:54–61.
18.
Sattar AA, Merck LA, Wespes E: Penile electromyography and its smooth muscle content: Interpretation of 25 impotent patients. J Urol 1996;155:909–912.
19.
Fan SF, Brink PR, Melman A, Christ GJ: An analysis of the maxi-K (KCa) channel in cultured human corporal smooth muscle cells. J Urol 1995;153:818–825.
1998
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.