Abnormal endothelial function in ED patients with normal nocturnal penile tumescence and rigidity: is it the role of psychogenic factors?

Abstract

Underlying endothelial dysfunction (EnD) may present in the early stage of ED or psychogenic ED. We retrospectively evaluated 191 ED patients with effective nocturnal penile tumescence and rigidity (NPTR) recording, including detailed medical and psychosexual history, International Index of Erectile Function-5 and vascular parameter. All patients were allocated into psychogenic and organic groups according to the NPTR test. Brachial artery flow-mediated dilation (FMD) was used to diagnose EnD, and ED patients were classified into two groups: non-EnD (FMDX10) and EnD (FMDo10). General and vascular parameters were compared between psychogenic and organic groups, and non-EnD and EnD groups with ED were compared in terms of NPTR parameters. In all, 48.7% and 51.3% patients were diagnosed as psychogenic and organic ED, respectively. 73.1% of the psychogenic patients had EnD and 39.8% organic patients had normal endothelial function. In all parameters, only the FMD value showed significant difference between psychogenic and organic ED groups (8.26±2.57 vs 9.16±2.76, P ¼ 0.020). No statistical difference was founded in NPTR parameters between non-EnD and EnD groups (P40.05). In conclusion, NPTR cannot effectively identify the underlying vasculogenic ED from psychogenic ED. Psychogenic causes may cause or aggravate EnD in these ED patients with normal NPTR.

Human Urine-Derived Stem Cells Alone or Genetically-Modified with FGF2 Improve Type 2 Diabetic Erectile Dysfunction in a Rat Model

“…Pathophysiology of diabetes mellitus-related ED is associated with endothelial dysfunction at an early stage [8], [36]. Impaired vasodilatory response is attributed to nitro oxide inhibition, smooth muscle cell dysfunction, and chronic nerve damage due to such long-term hyperglycemia [3], [4], [5], [6], [7].…”

Role of RigiScan parameters in differentiation of vascular erectile dysfunction

“…In ED assessment procedure, NPT monitoring was the first choice objective test to diagnose ED, aiming to give a differentiating diagnosis between psychogenic ED and organic ED, based on the concept that the psychogenic factors including stress, distress, anxiety and depression are unable to affect sleep‐related erections. Karacan et al and Fisher et al firstly reported its value in evaluating ED in 1970, and RigiScan device was introduced as an economical home‐monitoring device, aiming to evaluate NPT, that allowed male patients to be assessed in their normal surroundings (Huang et al, 2012). RigiScan test has facilitated the simultaneous, continuous measurement of both tumescence and rigidity of nocturnal penile erectile episodes with its rapid development.…”

“…The results are shown in Table 4. (Rastrelli et al, 2014), the elevated cost and the manner of its invasive procedures, together with its lack of standardisation, have limited its routine use in clinical practice (Kurbatov, Kuznetsky, Kitaev, & Brusensky, 2008 home-monitoring device, aiming to evaluate NPT, that allowed male patients to be assessed in their normal surroundings (Huang et al, 2012). RigiScan test has facilitated the simultaneous, continuous measurement of both tumescence and rigidity of nocturnal penile erectile episodes with its rapid development.…”

Weaker Masturbatory Erection May Be a Sign of Early Cardiovascular Risk Associated with Erectile Dysfunction in Young Men Without Sexual Intercourse

“…The device recorded several parameters, including number and duration of erections, tumescence and radial rigidity, the cumulative duration of erectile events, and the average tumescence and rigidity during events. Patients who did not meet any the following criteria in the device examination could be considered as NPTR abnormality [9–11]: (i) >three full erections during night; (ii) >70% of maximal tip rigidity; (3) >15 minutes of an average duration in erectile events; (iv) >60 minutes of total duration in erectile events.…”