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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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