[Critical evaluation of hidden organic factors causing impotence]

Many studies have pointed out the possibility of "masked" organic factors in erectile impotence, detectable only by means of laboratory investigations: mild hypogonadism, hyperprolactinemia, occlusions selectively located at the site of the sexual arteries, venous incompetence, subclinical neuropathies. This paper critically reviews these conditions, and the methods proposed to diagnose them. Impotence is a multifactorial disorder, involving in most cases psychological factors. Among the preceding conditions only severe venous incompetence can induce impotence only by itself. The other masked organic factors play only a partial role in most cases and need to be potentiated by another organic or psychological factor. In our experience, masked organic factors are present in 50% of the impotent males. But they play a significant role in only 25%.