Comparison of Rigiscan and Sleep Laboratory Nocturnal Penile Tumescence in the Diagnosis of Organic Impotence

Licht, Mark R.; Lewis, Ronald W.; Wollan, Peter C.; Harris, Cameron

doi:10.1097/00005392-199511000-00044

Cited by 9 publications

(13 citation statements)

References 10 publications

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“…Munoz and colleagues studied 17 patients with ED using NPT monitoring and noted that RigiScan underestimated rigidity at low levels [34]. In contrast, Licht and colleagues found that the RigiScan did not correlate with axial rigidity measurements at high levels of rigidity [42]. Other researchers measured the axial and radial rigidity in patients with ED and found a strong correlation between base rigidity and buckling pressure; however, tip rigidity measurement correlated poorly with axial measurements [33].…”

Section: Nocturnal Penile Tumescence (Npt) Testingmentioning

confidence: 99%

An Evidence-Based Perspective to Commonly Performed Erectile Dysfunction Investigations

Ghanem

Shamloul

2008

The Journal of Sexual Medicine

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Introduction Currently there is no universally accepted gold standard diagnostic test to differentiate psychogenic from physical erectile dysfunction (ED). Instead, sexual health specialists rely on a detailed history, a focused physical examination, and specialized diagnostic tests, to decide if the etiology of the ED is mainly psychogenic or organically caused. Aim In this review we point out the status of evidence-based principles in the area of diagnosis in Sexual Medicine. Methods We review the concepts of evidence-based medicine (EBM) in the area of medical diagnostic tests. We highlight four of the well-known diagnostic tests (penile duplex, pharmacoarteriography, pharmacocavernosometry/cavernosography [PHCAS/PHCAG], and nocturnal penile tumescence [NPT monitoring]) for ED evaluation within an evidence-based perspective. Main Outcome Measures Assessment of diagnostic tests for ED using principles of EBM. Results Several good diagnostic tests are useful in the evaluation of men with ED. However, modern evidence-based concepts—mainly the likelihood ratio—have not yet been applied to these tests to obtain their maximum clinical benefits. Conclusions While penile duplex/color Doppler has good evidence of supporting its use in the diagnosis of arteriogenic ED, data supporting its diagnosis of a physical disorder associated with cavernous venous occlusion dysfunction are lacking. PHCAS/PHCAG's main drawback is an unknown positive predictive value and a possibility of frequent false-positive results. NPT has many advantages when differentiating psychogenic from organic ED, however, several questions related to its physiological mechanisms do exist. [Correction added after online publication 14-Dec-2007: In the above reference for this article, the order of the author names has been updated.]

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Section: Nocturnal Penile Tumescence (Npt) Testingmentioning

confidence: 99%

An Evidence-Based Perspective to Commonly Performed Erectile Dysfunction Investigations

Ghanem

Shamloul

2008

The Journal of Sexual Medicine

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“…Indeed, fragmentation of REM sleep is generally associated with poorly maintained erections, reflecting the instability of the pro-erectile stimulus. All validation studies of the RigiScan screening device that have included polysomnography eliminated subjects with REM suppression secondary to any cause [40,42]. These "validation" studies have essentially "cherry picked" patients who have good (ie, normal) REM sleep.…”

Section: Patients With Apparent Abnormal Findings Using Home Erectionmentioning

confidence: 99%

Sleep-related erections: Neural mechanisms and clinical significance

Schmidt¹,

Schmidt²

2004

Curr Neurol Neurosci Rep

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Penile erections during rapid eye movement (REM) sleep are a robust physiologic phenomenon in all normal healthy males, irrespective of age. Given the involuntary nature of erections in sleep, sleep-related erection (SRE) testing has been used to differentiate psychogenic from organic impotence. The historical background of nocturnal penile tumescence, its current use, and common misconceptions of SRE testing are discussed. An animal model has been developed to study SRE mechanisms and has provided a new neural model regarding REM-related erectile control. The implications of these recent data on clinical SRE evaluation are presented. Finally, guidelines regarding SRE testing with polysomnography have not been available, contributing to a decline in formal SRE testing even though erections in sleep are commonly evaluated by urologists using home screening devices that do not record sleep. We propose a set of clinical indications when formal SRE evaluation in a sleep laboratory should be considered.

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“…25 According to Licht et al, base rigidity is also more accurate than tip measurements to evaluate erectile function. 26 2) Patients with lung involvement were not withdrawn from study because pulmonary abnormalities occur in approximately 90% of adults with SCD. 27 The percent of lung involvement and hydroxyurea treatment was similar in the 2 groups.…”

Section: Discussionmentioning

confidence: 99%