Question

How do you differentiate between psychological and organic erectile dysfunction?

• A. Nocturnal penile tumescence
• B. PIPE therapy
• C. Sildenafil induced erection
• D. Squeeze technique

Hint:

Which test relies on sleep erections that need no conscious arousal?

Answer 1

The Correct Option is A

Step 1: The goal is to tell apart psychogenic impotence from organic impotence. The best discriminator is whether reflex erections that are independent of conscious arousal are still intact.

Step 2: Nocturnal penile tumescence (NPT) refers to the spontaneous erections that occur during REM sleep, together with early morning erections. These depend on intact neural and vascular pathways but not on psychological arousal.

Step 3: In psychogenic erectile dysfunction the underlying nerves and blood vessels are normal, so NPT and early morning erections are preserved. In organic erectile dysfunction the vascular or neural apparatus is damaged, so NPT is reduced or absent. Demonstrating preserved NPT therefore points to a psychological cause.

Step 4: The other options are treatments, not diagnostic tests. PIPE (intracavernosal injection) therapy and sildenafil are used to treat erectile dysfunction, and the squeeze technique is a behavioural treatment for premature ejaculation. Hence the answer is nocturnal penile tumescence.