Erectile Impotence – Clinical Experience with the Phalloplethysmography

Abstract

The clinical experience and results of NPT recording on three different groups of patients (a group of normals, a group with high suspicion of psychogenic impotence and a group of organic impotence with a well-known etiology) are reported here. A new classification of erectile capacity which is not only based on change in circumference of the penis, but also on duration of complete erection and rigidity of the penis is proposed. The phalloplethysmography, which is based on the REM-related tumescence is a reliable method for discrimination between organic and psychogenic impotence. A rigidity test, however, is essentially for the detection of insufficient rigidity in spite of normal penile expansion during NPT recording.

A comprehensive review of monitoring methods for erectile dysfunction diagnosis

“…More than two decades after the use of the mercury strain gauge by Fisher et al in 1965, Leliefeld et al used a modified mercury strain gauge, named the Phalloplethysmography to conduct an experiment in 1982 29 . The Phalloplethysmography consists of 2 strain gauges filled with mercury that record the changes in penile circumference during erection (Figure 1A).…”

“…Observations are made on the subject's penile palpation and the likelihood of the erected penis buckling after pressure is applied to the glans of the penis. Based on the observations, penile rigidity is evaluated and categorized as either sufficient or insufficient for vaginal penetration 29 . Though the modifications in phalloplethysmography allowed penile rigidity to be measured, the constant use of artificial pressure applied to the glans of the penis may cause discomfort and influence the subject's sleep.…”

“…One of the strain gauges is placed at the base of the penis, while the other is located at the corona of the F I G U R E 1 (A) Illustrations of the Phalloplethysmography, it will be used together with two mercury strain gauge to record the change in circumferences. 29 (B) Illustration of RigiScan® Plus, two rings are connected to the penile shaft to monitor tumescence and rigidity. 34 (C) Illustration of stamp test whereby a stamp ring will be worn onto the penile shaft for each test.…”

“…Based on the observations, penile rigidity is evaluated and categorized as either sufficient or insufficient for vaginal penetration. 29 Though the modifications in phalloplethysmography allowed penile rigidity to be measured, the constant use of artificial pressure applied to the glans of the penis may cause discomfort and influence the subject's sleep. Limitations such as the requirement of skilled technicians to operate and incurring additional costs for manpower are still present in the phalloplethysmography.…”

“…More than two decades after the use of the mercury strain gauge by Fisher et al in 1965, Leliefeld et al used a modified mercury strain gauge, named the Phalloplethysmography to conduct an experiment in 1982. 29 The Phalloplethysmography consists of 2 strain gauges filled with mercury that record the changes in penile circumference during erection (Figure 1A). One of the strain gauges is placed at the base of the penis, while the other is located at the corona of the F I G U R E 1 (A) Illustrations of the Phalloplethysmography, it will be used together with two mercury strain gauge to record the change in circumferences.…”