[Diagnosis of erectile impotence]

Abstract

In patients with erectile dysfunction (ED), the diagnostic procedure depends on the efficiency of the method and the implications of the results for treatment. The procedures to be considered can be integrated into a flowchart. Following screening by means of intracavernous drug injection the etiology can be classified with an adequate degree of certainty into one of three main groups. A preliminary diagnosis of nonvascular ED can be confirmed by psychological (interview, psychometric tests) and neurophysiological investigations. An arterial etiology can be confirmed by Doppler ultrasonography or, if revascularization is planned, by arteriography. A venous-type ED with a high MF value on cavernosonography is suspicious of an obstructive arteriopathy. Measurement of the systemic-penile occlusion pressure gradient appears to be a sensitive test for the examination of patients with ED of vascular etiology and should be carried out before the treatment is planned.