[Neurogenic impotence]

Until recently, the management of impotence was mainly concerned with the distinction of psychogenic from organic causes of erectile failure. Patients with the former were offered psychosexual counselling, while surgery, principally in the form of prosthesis implantation, was reserved for those with organic impotence. With the identification of pharmacologic regimes that can successfully induce erection, it has become necessary to distinguish between vascular and neurogenic causes of erectile failure, since it is mainly the latter patient group that can profit from an intracavernosal injection therapy with papaverine and phentolamine. Neurogenic erectile failure is further classified according to lesion localization and underlying disease.