Caverno-occlusive and autonomic dysfunction: a new concept in young patients.

We attempted to identify the etiology of erectile dysfunction in 50 male patients with a mean age of 31.4 (25-42) years. The physical and neurological examinations, history, biochemistry and serum testosterone and prolactin levels were within normal limits. Pharmacopenile duplex ultrasonography, corpus cavernosum electromyography (CC-EMG) and cavernosometry were performed. Smooth muscle tone and the relaxation response after intracavernous papaverine and sodium nitroprusside injections were evaluated by CC-EMG. Autonomic dysfunction has been defined as increased electrical activities after visual sexual stimulation and lowered amplitudes despite normal smooth muscle content. Our definition is similar to this: paradoxically increased electrical activities after intracavernous injection. Caverno-occlusive dysfunction (COD) and accompanying pathologies were found in 38 patients (76%) with pure COD in 26 (52%), COD and arterial pathology in 2 (4%) and COD + autonomic dysfunction in 10 patients (20%). Amplitudes of cavernous electrical activity were low in 32 of 38 patients with COD. These high COD and autonomic dysfunction rates led us to examine these pathologies on molecular and electrophysiological bases.