Organic Impotence:
Neurologic Abnormalities
Patient Identification: LTM
General Medical Hx
technical writer, single, 0 children
age: 33
med.dx : none at the time of this evaluation, however based on the test
results of this evaluation AODM has been confirmed
surgeries: knee, 1970
smoker: no
alcohol: none
meds: none
Sexual Hx
• difficulty obtaining and maintaining erections since 1981
• complains of decreased penile sensation
• denies A.M. and nocturnal erections
• no improvement with other forms of sexual stimuli
• erections are never sufficient for vaginal penetration
• no improvement in erections with position changes
• penile curvature: denies
• last successful intercourse: 1981-1982
• ejaculation intact – oral sex and masturbation, but sometimes difficult
• premature ejaculation: denies
• libido: normal
• has noted difficulty maintaining relationships secondary to erectile
dysfunction
• bladder symptoms: difficulty starting stream 70% of time
• bowel symptoms: diarrhea
• sleep disturbances: none
Physical Exam
essentially WNL
BP: not available
Test Results
Doppler
Rt.
Lt.
Mid
Pre-Exercise (PBI)
.91 – NI.
.86 – NI.
.84 – NI.
Post-Exercise (PBI)
.64 – Abnl.
.85 – NI.
.79 – NI.
Electrophysiological Tests
NCV of DNP
PER
BCR
39.8 M/sec/ - Abnl.
43.26 msec. – NI.
45.34 msec. – NI.
RigiScan: Abnl. X 3 nights – NI. Tumescence of base and tip (even though rigidity was noted in the 50-70% range, it occurred alternately at the base and tip of the penile shaft during different events)
Final Dx
organic impotence associated with neurological abnormalities
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