The clinical application of dorsal penile nerve cerebral-evoked response recording in the investigation of impotence.
OBJECTIVE
To determine whether recording of penile cerebral-evoked response (CER) is useful in the assessment of men with impotence.


METHODS
A total of 280 impotent men underwent CER recording as part of an assessment for a complaint of impotence. They were categorized from findings in the history and examination as having non-neurogenic impotence (n = 106), impotence related to existing neurological disturbance (n = 67), type I diabetes (n = 49) or type II diabetes (n = 58). Increased period of latency or absence of first positive peak (P1) on CER were used as the criteria for an abnormal response with reference to an age-matched control group of potent men (n = 34).


RESULTS
Overall, impotent men with diabetes or a history of neurological disturbance had significantly longer P1 latencies and lower response amplitudes compared with the control group. In contrast the CER recorded from men with non-neurogenic impotence was similar to the control group. Individual results showed an increased period of latency or absence of P1 in 100 (36%) impotent men, 72 (72%) of whom were diabetic or had a history of neurological dysfunction. CER abnormalities were associated with neurological signs on physical or cystometrographic examination in 40 (40%) individuals.


CONCLUSIONS
Although technically satisfactory, the clinical usefulness of CER recording is limited by the poor discriminatory value of response latencies. Most abnormal results could be predicted by the presence of diabetes or pre-existing neurological dysfunction, or by evidence of neurological deficit on physical examination. The test is not therefore suitable for routine clinical assessment of impotence but may be worthwhile if objective evidence of penile sensory dysfunction is required.
Pickard
R S
RS
Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK.
Powell
P H
PH
Schofield
I S
IS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D048909:Diabetes Complications; D007172:Erectile Dysfunction / Q000209:etiology / Q000503:physiopathology*; D005071:Evoked Potentials; D006801:Humans; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000294:innervation*; D011930:Reaction Time; D012684:Sensory Thresholds