Erectile dysfunction as the presenting symptom of a pheochromocytoma

We report the case of a 59-year-old man with a pheochromocytoma in which erectile dysfunction was the main symptom. Erectile function was related to the amount of noradrenaline secreted by the tumor, as was determined when recurrence of the malignancy was diagnosed twice. Erectile function could be restored by lowering the level of noradrenaline excretion, either by removal of the noradrenaline-producing tumor or by treatment with doxazosin. By stimulating alpha-1-adrenoceptors, high levels of noradrenaline are likely to result in excessive contraction of the corpus cavernosum and penile vessels and, thereby, cause erectile dysfunction.