[Henry IV of Castilla (1454-1474). An exceptional urologic patient. An endocrinopathy causing the uro-andrological problems of the monarch. Impotence and penile malformation (III)].
OBJECTIVE
To review, in accordance to contemporary and current chronicles and manuscripts, all data known about impotence and presumptive penile malformation suffered by Henry IV of Castile. Although currently the monarch's homosexuality is almost totally rejected, because according to many authors slandering, mainly of the sexual kind, was used as a political arm to discredit him by his enemies, it is yet to be demonstrated if his erectile dysfunction and presumptive genital anomaly were also slanderly disseminated by his detractors to avoid recognizing his daughter Juana "La Beltraneja" as successor to the throne.


METHODS
We reviewed a total of 10 chronicles, 5 contemporary texts and manuscripts, and 25 books about the figure of Henry IV published before year 2000, analyzing medical works in detail, particularly those from Marañon, Eisenberg, and Irvine and Mackay, who studied both pathologies trying to differentiate if both diseases could be justified by the kind of endocrinopathy the monarch suffered.


RESULTS
Although it is understandable that the study could be mistaken by document manipulation undertaken during Henry IV's life and posteriorly during the reign of the "Catholic Kings", and due to the lack of impartiality of some of his chroniclers, it is my opinion that the most probable cause of Enrique IV's erectile dysfunction was a GH and prolactine producing hypophyseal tumor, that he suffered from his youth producing complete impotence and acromegaly. It is not well documented if the Monarch also suffered a congenital penile anomaly.
Maganto Pavón
Emilio
E
Servicio de Urología, Hospital Ramón y Cajal, Madrid, España.
D007172:Erectile Dysfunction / Q000266:history*; D005197:Famous Persons; D049668:History, 15th Century; D006801:Humans; D008297:Male; D010413:Penis / Q000002:abnormalities*; D010781:Photography; D013030:Spain; D014572:Urology / Q000266:history*