Nocturnal Penile Erections: The Role of RigiScan in the Diagnosis of Vascular Erectile Dysfunction

Abstract

Introduction To determine the etiology of cases with organic erectile dysfunction (ED), invasive techniques are needed that can induce patient anxiety and disturb test results. Aim To find any special patterns of nocturnal penile tumescence and rigidity (NPTR) records in cases of vasculogenic impotence that can differentiate cases of arterial and venous origin without resorting to the more invasive diagnostic tests. Methods This study included 95 cases of ED (77 cases with abnormal NPTR records plus 18 cases with normal NPTR). History taking and clinical examination with estimation of serum androgen hormones and postprandial blood glucose were done. All patients were then subjected to the following: NPTR monitoring using RigiScan device (Dacomed Corporation, Minneapolis, MN, USA), pharmacopenile duplex ultrasound examination, and redosing pharmacocavernosometry. According to the results of these tests, patients were classified into four groups: psychogenic, arteriogenic, venogenic, and combined arteriogenic–venogenic ED groups. Receiver operator characteristic (ROC) curve analysis of the different RigiScan parameters of venogenic group vs. the arteriogenic group was done. Best parameters were then retested by using them in prediction of veno-occlusive dysfunction (VOD) in all studied patients. Main Outcome Measures Different RigiScan parameters: number of events, duration of best episode, base tumescence, base rigidity, tip tumescence, and tip rigidity. Results RigiScan parameters were statistically lower in venogenic than in arteriogenic group and were more correlated with flow to maintain than the peak systolic velocity. ROC curve analysis showed that VOD can be predicted if the duration of the best event is <11.5 minutes (diagnostic accuracy 83.7%) or tip rigidity is <36.5% (diagnostic accuracy 81.6%). On generalizing these values in all patients, duration of best event showed diagnostic accuracy of 88.4%. Conclusion VOD can be predicted if duration of the best event of NPTR monitoring is less than 11.5 minutes, but the presence of concomitant arterial dysfunction cannot be excluded.

Changes in erectile organ structure and function in a rat model of chronic prostatitis/chronic pelvic pain syndrome

“…The IIEF lacks information about the aetiology of sexual disorders (Rosen et al ., ), and the IIEF cannot differentiate between organic and functional ED. Besides, in the evaluation of human erectile function, nocturnal penile tumescence (NPT) monitoring is one of the most reliable methods to diagnose ED and to differentiate psychogenic from organic ED (Elhanbly & Elkholy, ). However, there have been no relevant studies that assessing erectile function in patients with CP/CPPS using NPT monitoring.…”

Age-stratified cut-off points for the nocturnal penile tumescence measurement using Nocturnal Electrobioimpedance Volumetric Assessment (NEVA®) in sexually active healthy men

“…Kassouf & Carrier () concluded that the use of only IIEF cannot be a tool to diagnose or compare specific vascular causes of ED. Therefore, the NPT measurement should be considered an essential diagnostic tool for ED diagnosis with a high accuracy in men with suspected ED (Tokatli et al ., ; Elhanbly & Elkholy, ). An increase of ≥15 min in the penile tumescence over 200% at the tip was interpreted as a normal and sufficient erection in all men regardless of age, when the Neva ® device was applied for NPT measurement.…”

Varicocele is associated with hypogonadism and impaired erectile function: a prospective comparative study

“…Rigiscan test is useful in the diagnosis of erectile dysfunction (ED) to distinguish organic and psychogenic ED (Marshall, Morales, & Surridge, ). A normal NPT is defined as more than three erectile episodes with a duration over 10 min as well as tip and base rigidity ≥70%, and tip tumescence ≥2 cm and base tumescence ≥ 3 cm (Elhanbly & Elkholy, ). These diagnostic criteria have been a focus of debate and have stressed the diagnostic value of erectile events per night and the data on rigidity and tumescence, while other parameters, including RAU tip, TAU tip, RAU base and TAU base, are less evaluated, which has been implicated to have a role in ED diagnoses (Elhanbly, Elkholy, Elbayomy, Elsaid, & Abdel‐gaber, ).…”