Visual Erotic Stimulation Test for Initial Screening of Psychogenic Erectile Dysfunction

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.

Changes in Erectile Response to Repeated Audiovisual Sexual Stimulation

“…There are two major problems associated with this audiovisual stimulation test. (1) The diagnostic value of this method in differentiating psychogenic from organic impotence has not yet been completely established [10, 11, 12, 13, 14]. In our study, the average maximal rigidity of penile erection, which was sustained for more than 5 min during audiovisual stimulation, at the tip and base of the penile shaft was 46% in patients with psychogenic impotence and 37% in normal men.…”

“…Therefore, audiovisual sexual stimulation may not help to differentiate patients with erectile dysfunction from normal men. (2) Several factors, such as repetitive viewing of the same erotic video, habituation to erotic movies, lack of interest in erotic movies, deterioration in general health, age, or psychological factors (severe psychotic disorders or anxiety associated with unfamiliar surroundings, the examination itself, and the recording device) may result in false-negative responses [11, 15]. To our knowledge, no study has previously reported whether habituation to erotic movies or viewing the same or a similar movie influences the erectile response during audiovisual stimulation.…”

“…Real-time monitoring of erectile response to audiovisual sexual stimulation is a widely used screening test to distinguish psychogenic from organic impotence because it is simple, practical, and inexpensive [10, 11]. If a patient previously viewed a certain erotic movie or is habituated to viewing such movies, erectile responses during audiovisual stimulation would be expected to be diminished, but this has not yet been reported.…”