An assessment and comparison of nocturnal penile erection, audiovisually stimulated erection and vibration-induced erection in normal young adults / 대한비뇨기과학회지

To get the standard and marginal rigidity of physiologic erection in young Korean men with normal potency, nocturnal penile erection(NPE) and audio-visually stimulated erection(AVSE) were monitored using RigiScan in 30 young volunteers with normal potency aged from 21-35 years. Vibration induced erection was also assessed by bucking. The results were as follows. 1. Regarding to NPE, maximal rigidity lasting for more than 5 minutes was 40-70% in 4(10.3%) and more than 70% in 26 (89.7%) with mean+/-SD of 78.43+/-8.02 %. The maximal rigidity lasting for more than 10 minutes was 40-70% in 6(20%) and more than 70% in 24(80%), with mean+/-SD of 74.43+/-8.02%. 2. Regarding to AVSE, maximal rigidity lasting for more than 5 minutes was 40-70% in lt3.3 %) and more than 70% in 29(96.7%) with mean+/-SD of 81.30+/-7.18%. The maximal rigidity lasting for more than 10 minutes was 40-70% in 2(6.7%) and more than 70% in 28(93.3%), with mean+/-SD of 77.63 + 7.87%. Twenty seven men(90%) showed positive response to VIE test. but 3 with normal NPE and AVSE showed negative response to VIE test. Therefore, young potent men showed higher amplitude of maximal rigidity in AVSE than in NPE. and VIE test had the highest false negative response rate. The rigidity of 40% lasting 10 minutes was the lower limit of normal NPE and AVSE.

Normal values in the interpretation of nocturnal penile erection / 대한비뇨기과학회지

Nocturnal penile erection monitoring(NPEM) is a widely used technique for the differential diagnosis of impotence. However. minimal requirements in various parameters of nocturnal penile erection monitoring. that is demanded for vaginal penetration. has not yet been elucidated. To delineate the minimal tumescence and rigidity for vaginal penetration we studied thirty-three candidates with normal sexual life and two hundred fifty nine erectile failure patients using RigiScan. All normal candidates performed one session per night for 3 days. The cut off values of average tumescence and duration of rigidity were determined based on the 95 percentiles of the norma1 candidates. The 95 percentiles of average-tumescence were 6.6cm in the base and 6.4cm in the tip or the penis. The 95 percentiles or the duration of rigidity more than 60% were 9 minutes in the base and 5 minutes in the tip. Those values of rigidity more than 40% were 11 and 6 minutes in the base and tip, respectively. We adopted the values of rigidity more than 60% rather than 40% as normal cut off value. With these cut-off values, two hundreds fifty nine impotence patients were evaluated for their features with the maximum figures of their tumescence and time of rigidity which measured in the same way. One hundred forty eight patients ( 57.1%) were in normal values. Among abnormal 42.9%, 92(35.5% ) cases showed insufficient rigidity, 61 (23.5%) cases of dissociation of rigidity between the tip and the base of penis and 59(22.8%) cases with uncoupling between rigidity and circumferential expansion. Therefore, we suggest that these cut-off values are acceptable to evaluate the performance of erectile failure patient.

A Clinical Comparative Study between Visual Stimulated Erection and Nocturnal Penile Erection by RigiScan / 대한비뇨기과학회지

With 80 cases of impotent patients (30 psychogenic, 50 organic : 39 vasculogenic, 2 neurogenic, 5 vasculogenic + neurogenic, 4 undetermined). we compared the penile rigidity and the change of penile circumference between the visual stimulated erection (VSE) and nocturnal penile erection (NPE) by RigiScan. The results were obtained as follows. 1. In psychogenic impotent patients, the maximal degree of penile rigidity of the basal and tip portions were similar in 21 NPE (70.0%) and 22 VSE (73.3%), and 6 VSE of above showed the rigidity below 10%. All 9 NPE (100%) and 5 VSE (62.5%), out of 9 NPE and 8 VSE dissociated cases, were more higher degree of rigidity in base than that of tip. 2. In organic impotent patients, the maximal degree of penile rigidity of the basal and tip portions were similar in 29 NPE (58.0%) and 39 VSE (78.0%), and 10 NPE (34.5%) and 22 VSE (56.4 %) of above showed the rigidity below 40%. Among the remainders 21 NPE and 11 VSE, the cases who represented dissociation, 18 NPE (85.7%) and 9 VSE (81.8%), the majority, were more higher degree of rigidity in base than that in tip. 3. There were 29 psychogenic (96.7%) and 30 organic (60.0%) impotent patients in NPE, and 7 psychogenic (23.3%) and 5 organic (10.0%) in VSE, who represented over 40% of rigidity more than 5 minutes both in tip and base of penis. 4. Among the all 80 cases, the changes in penile circumferences of the basal and tip portions were similar in 41 NPE (51.3%) and 39 VSE (48.8%), and in remainders, 26 NPE (66.7%) and 34 VSE (82.9%) showed more changes in base than tip. Therefore, we concluded that NPE is more significant than VSE for the diagnosis and evaluating the degree of organic impotence because the rigidity of NPE were more higher than VSE both in psychogenic and organic impotent patients. In the other hand, however, if VSE represents sufficient rigidity, enough rigidity will be expected in NPE, so VSE is useful screening test before NPE.

Clinical Value of Nocturnal Penile Erection by Rigiscan / 대한비뇨기과학회지

Continuous and simultaneous recording of nocturnal penile rigidity and tumescence is preferred than measuring tumescence alone to define the features of nocturnal penile erection and differentiate psychogenic from organic impotence. Rigiscan is suitable for this purpose. Authors studied to define the features of nocturnal penile erection by rigiscan in 24 normal Koreans and 18 patients with erectile dysfunction. The results were as follows : 1. In normal group, the number of normal erection was 4.2+/-0.9 times per night, duration was 21.1+/-7.4 minutes at tip and 26.3+/-9.8 minutes at base, tumescence change was 1.81+/-0.51 cm at tip and 2.23+/-0.72 cm at base, rigidity was 55.7+/-19.6 per cent at tip and 66.3+/-12.0 per cent at base. Maximal duration was 34.2+/-14.9 minutes at tip and 39.0+/-15.1 minutes at base, maximal tumescence change was 2.28+/-0.83 cm at tip and 2.64+/-0.78 cm at base, maximal rigidity was 65.4+/-11.8 per cent at tip and 75.8+/-12.5 per cent at base. The higher the age, the shorter the duration and number of events were(p<0.05). 2. In patient group, normal rigigram showed in 6 patients(3 of psychogenic, 3 of posterior urethral injury). Event and duration were shorter than normal group(p<0.05). The findings of flat trace or abnormal erection provide valuable information to screen the organic impotence.