Diagnosis and treatment of male erectile dysfunction.
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Biomedical subjects
Publications and source records attributed to L E Beutler.
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Thirty organically impotent men were contrasted with 21 psychogenically impotent men and 17 normal controls. Distinctions among sexual attitudes, sexual behaviors, and sexual interests were evaluated on the Sex Form. Results suggest that impotent men can be reliably distinguished from non-impotent men on the basis of their use of activity rather than fantasy in coping with life's problems and their interest in receiving treatment for their condition. Separate comparisons between the control group and the two impotent groups further suggest that both can be reliably distinguished from normals. It is more difficult, however, to distinguish between organically and psychogenically impotent men on the basis of sexual interests, attitudes, and behavior. The findings suggest, however, that impotent men generally and psychogenically impotent men in particular tend to be individuals who have relatively low sexual drive, diminished sexual knowledge, and who are prone to active ways of coping with stress. The results are discussed in light of previous findings.
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Erectile impotence can now be treated with a device that mimics a natural erection. Between 1973 and 1977, we implanted an inflatable prosthesis in 245 men (235 with organic impotence and ten with psychogenic impotence). Of these, 234 are able to use the device to their satisfaction; no failures have occurred in the 152 cases treated in 1976 and 1977. The success of this treatment rests in part on the careful selection of patients by a team--a urologist, a sleep researcher, a psychologist, and a psychiatrist--each evaluating the patient independently. Our experience suggest that erectile impotence may be more common than generally believed and that impotence from organic causes may account for a greater percentage of cases than formerly thought.
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The authors conducted a study of nocturnal penile tumescence (NPT) in 35 diabetic men, aged 33 to 70, who complained of impotence and in 35 age-matched control subjects. EEGs and other measurements showed that the diabetic men as a group exhibited significant reductions in the total amount of NPT and in the amount and frequency of full erection, thus suggesting that impotence in this cohort was organogenic. Although NPT monitoring represents an advance over the less precise traditional procedures for the differential diagnosis of impotence, the authors stress the need for more research in this area.
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Rapid advances in methods of treating sexual impotence have produced concomitant demands for more specific diagnosis and determination of prognosis. Herein are presented guide lines for a rapid screening procedure that has diagnostic and prognostic utility. Use of 2 decisional rules for the Minnesota Multiphasic Personality Inventory, an easily administered and scored psychological test, can provide assistance to the urologic surgeon in determining the suitability of a candidate for a corrective operation. Case histories illustrate the value of this test in making treatment recommendations and assessing prognosis.
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34 male and 34 female hospitalized psychiatric patients were divided into field-independent and field-dependent groups on the basis of rod-and-frame test performance and their MMPI scores were compared. A multiple discriminant analysis followed by a series of 2 X 2 factorial analyses of variance was used to assess the results. As in previous studies, more similarities than differences were found between the two cognitive styles. However, field-independent subjects tended to be more unconventional, aggressive, antisocial, and perhaps defensive than field-dependent subjects. Explanations of results were explored in reference to previous findings.
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