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A comparison of Nocturnal Penile Tumescence and penile response to erotic stimulation during waking states in comprehensively diagnosed groups of males experiencing erectile difficulties

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The erectile responses of 13 nondysfunctional males and 48 dysfunctional males were compared during Nocturnal Penile Tumescence (NPT) and during exposure to erotic videotapes. The results showed distinct patterns of NPT and daytime responding that could differentiate the various subgroups: those displaying (i) no dysfunction; (ii) vasculogenic erectile dysfunction; (iii) high risk for erectile dysfunction (organic and psychogenic); (iv) psychogenic dysfunction; reactive to erotica; and (v) psychogenic dysfunction; nonreactive to erotica. Subjects participating in this study underwent a comprehensive medical and psychological screening to place them in each subgroup. The penile circumference response to erotic stimuli used in conjunction with NPT response appeared useful in differentiating subgroups of erectile dysfunction and suggested the need for further diagnostic refinement in this area. The majority of vasculogenic dysfunctional subjects experienced greater erection responses during exposure to erotic stimulation than during NPT; several of these subjects achieved almost full erections in waking states but were practically flaccid at night. The discussion covers diagnostic and therapeutic implications.

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  1. Abel, G. (1987, March). Sexual dysfunction in diabetic males. In Carey, M. P. (chair),Sexual Functioning and Chronic Disease. Symposium conducted at the eighth meeting of the Society of Behavioral Medicine, Washington, DC.

  2. Abel, G., Becker, J., and Cunningham-Rahter, J. (1982). Differential diagnosis of impotence in diabetics: The validity of sexual symptomatology.Neurourol. Urodynamics. 1: 57–69.

  3. Barlow, D. (1986). Causes of sexual dysfunction: The role of anxiety and cognitive interference.J. Consult. Clin. Psychol. 2: 140–148.

  4. Derogatis, L., and Meyer, J. (1979). A psychological profile of the sexual dysfunctions.Arch. Sex. Behav. 8: 201–223.

  5. Fisher, C., Shiavi, R., Lear, H., Edwards, A., Davis, D., and Witken, A. (1975). The assessment of nocturnal REM erection in the differential diagnoses of sexual impotence.J. Sex Marital Ther. 1: 277–289.

  6. Hatch, J. (1981). Psychophysiological aspects of sexual dysfunction.Arch. Sex. Behav. 10: 49–64.

  7. Heiman, J. (1975). The physiology of erotica: Women's sexual arousal.Psychol. Today 8: 90–94.

  8. Heiman, J. (1978). Uses of psychophysiology in the assessment and treatment of sexual dysfunction. n LoPiccolo, J., and LoPiccolo, L. (eds.),Handbook of Sex Therapy Plenum Press, New York.

  9. Karacan, I. (1970). Clinical value of nocturnal REM erection in the differential diagnosis of sexual impotence.Med. Aspects Hum. Sex. 4: 27–34.

  10. Kockott, G., Feil, W., Ferstl, R., Aldenhoff, J., and Besinger, V. (1980). Psychophysiological aspects of male sexual inadequacy: Results of an experimental study.Arch. Sex. Behav. 9: 477–493.

  11. Malhotra, C., Balko, A., Bansal, S., Wincze, J., and Susset, J. (1986). Cavernosography in conjunction with artificial erection for evaluation of venous leakage in impotent males.Radiology 161: 799–802.

  12. Marshall, P., Surridge, D., and Delva, N. (1981a). The role of nocturnal penile tumescence in differentiating between organic and psychogenic impotence: The first stage of validation.Arch. Sex. Behav. 10: 1–10.

  13. Marshall, P., Morales, A., and Surridge, D. (1981b). Unreliability of nocturnal penile tumescence recording and MMPI profiles in assessment of impotence.Urology 17: 136–139.

  14. Melman, A., Kaplan, D., and Redfield, J. (1984). Evaluation of the first 70 patients in the Center for male sexual dysfunction of Beth Israel Medical Center.J. Urol. 131: 53–55.

  15. Segreaves, T., and Schoenberg, H. (1985).Diagnosis and Treatment of Erectile Disturbances Plenum Press, New York.

  16. Wagner, G., and Green, R. (1981).Impotence: Physiological Psychological, Surgical Diagnosis and Treatment Plenum Press, New York.

  17. Wilder, J. (1958). Modern psychophysiology and the law of initial value.Am. J. Psychother. 12: 199–221.

  18. Wincze, J., Hoon, P., and Hoon, E. (1976). A comparison of the physiological responsivity of normal and sexually dusfunctional women during exposure to an erotic stimulus.J. Psychosom. Med. 20: 44–50.

  19. Wincze, J., Venditti, E., Berkow, D., and Mavissakalian, M. (1980). The effects of a subjective monitoring task in the physiological measure of genital response to erotic stimulation.Arch. Sex. Behav. 9: 533–545.

  20. Zuckerman, M., Neeb, M., Ficher, M., Fishkin, R., Goldman, A., Fink, P., Cohen, S., Jacobs, J., and Weisberg, M. (1985). Nocturnal penile tumescence and penile responses in the waking state in diabetic and nondiabetic sexual dysfunctionals.Arch. Sex. Behav. 14: 109–130.

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Correspondence to John P. Wincze Ph.D..

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Wincze, J.P., Bansal, S., Malhotra, C. et al. A comparison of Nocturnal Penile Tumescence and penile response to erotic stimulation during waking states in comprehensively diagnosed groups of males experiencing erectile difficulties. Arch Sex Behav 17, 333–348 (1988). https://doi.org/10.1007/BF01541811

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Key words

  • erectile dysfunction
  • psychophysiology
  • nocturnal penile tumescence
  • erotic arousal