Noninvasive assessment of impotence

The examinations described provide quantitative data on hemodynamics of the erectile process. Comprehensive study cannot be totally noninvasive because it does require measurements of intracavernous pressure. Patients selected for invasive study should exhibit normal neurologic function. These tests generally do not display anatomy underlying the physiologic disorder, although ultrasound has great promise in this regard. Angiography is needed for rational planning of operative procedures. Angiographic examination that includes arteriography of large and small arteries and delineation of cavernosal venous drainage or cavernosography defines both the location and the nature of defects causing erectile failure. It is our belief that both noninvasive and invasive tests (physiologic measurements to assess penile blood flow and cavernosal competence and comprehensive angiography using artificial erection) must be obtained prior to operation.