Visual Erotic Stimulation Test for Initial Screening of Psychogenic Erectile Dysfunction: A Reliable Noninvasive Alternative?

Abstract

A positive response to visual erotic stimulation is strongly indicative of a predominantly psychogenic cause of erectile dysfunction. In combination with patient sexual history and pharmacological erection testing, visual erotic stimulation can be performed as an initial, minimally invasive test for cost-effective screening of psychogenic impotence.

Comparative Study between AudiovisualSexual Stimulation Test and Nocturnal Penile Tumescence Test Using RigiScan Plus in the Evaluatio n of Erectile Dysfunction

“…They reported that in 32 patients with normal erotic erections, the compatibility ratio with nocturnal erection was 63%, while in 105 patients with abnormal erotic erections, the compatibility ratio was 47%. Martins and Reis [11] reported that in a total of 76 patients the AVSS test using the RigiScan discriminated psychogenic ED with 71% sensitivity and 96% specificity. However, to our knowledge, no comparative studies between the findings of AVSS and NPT tests using the RigiScan system have been previously reported in the English literature.…”

“…The videotape material used in this study included a selection of various types of sexual stimuli assembled from several commercial films of heterosexual activity with sound. A normal erectile response to AVSS included rigidity of 70% or greater at tip and base of the penis [11].…”

Male Sexual Function and Its Disorders: Physiology, Pathophysiology, Clinical Investigation, and Treatment

“…Several adaptations for NPT monitoring were described to reduce the cost of nocturnal sleep laboratory testing and/or to improve the diagnostic efficiency of tumescence monitoring. These include monitoring during the following: 1) morning naps preceded by modest sleep deprivation (229,230); 2) audiovisual and/or fantasy stimulation (231)(232)(233); 3) erectile response to intracavernous vasoactive drug administration with or without audio-visual enhancement (230); 4) pulse Doppler analysis of penile arteries with audio-visual enhancement of the erectile response (234,235); 5) erotic audiovisual enhancement of the erectile response to vibrotactile stimulation (236); and 6) affective and cognitive response to erotic audio and fantasy stimulation (237). However, several pitfalls of real-time tumescence and rigidity testing in its present form exist and need to be addressed before a suitable adaptation for general screening can be recommended.…”

The value of audiovisual sexual stimulation with virtual reality in diagnosing erectile dysfunction

“…However, the traditional AVSS test may experience a low response rate or high false negative response rate induced by inadaptable testing surroundings, the subject’s psychological factors, and poor sexual arousal to a conventional monitor, which may limit its widespread application in clinical practice. 13 , 14 In Kim et al’s study, 14 the positive response rates (duration of average maximal rigidity ≥5 minutes) of conventional AVSS were 37% in normal men. Furthermore, only 3 (13.6%) of the 22 normal men sustained a penile rigidity of 70% or more for more than 5 minutes, and 10 (45.5%) had a rigidity of 40% or more.…”