Routine psychophysiological screening of 384 men with erectile dysfunction.

Psychophysiological screening was carried out on 384 consecutive patients with erectile dysfunction of psychogenic or psychogenic-organic origin. Visual sexual stimulation with penile vibration caused a satisfactory erection in roughly 50% of patients. Nonresponders subsequently produced a good penile response with intracavernous injection of vasoactive substance. Orgasm-ejaculation can occur in the absence of a full erection. In such cases subsequent intracavernous injection brought about a (near) full erection. A first intracavernous injection was most effective when combined with visual and vibrotactile stimulation. The magnitude of the response to such stimulation is useful to enable the doctor to prescribe the lowest dose of a vasoactive substance, thus minimizing the risk of priapism. Preferably, drug treatment of men with erectile dysfunction should be combined with sexual counseling or therapy.