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Why aged men become impotent.

T Mulligan¹, P G Katz

¹Division of Geriatric Medicine, Medical College of Virginia, Richmond.

Archives of Internal Medicine

|June 1, 1989

Summary

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Erectile impotence in older men is often caused by combined vascular and neurologic issues. Some cases are reversible or treatable, highlighting the need for thorough evaluation in geriatric patients.

Area of Science:

Geriatric Medicine
Urology
Andrology

Background:

Erectile impotence is common in aging men, but detailed etiological data are limited.
Understanding the causes of impotence in older adults is crucial for effective management.

Purpose of the Study:

To investigate the pathophysiologic mechanisms underlying erectile impotence in a cohort of elderly male veterans.
To identify the prevalence of different causes of impotence in this population.

Main Methods:

A comprehensive evaluation of 121 impotent male veterans (mean age 68 years).
Methods included medical history, physical examination, metabolic assessment, nocturnal penile tumescence monitoring, and vascular and neurologic assessments.

Main Results:

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The most common cause of impotence was the combination of neurologic and vascular disorders (30.3%).
Other significant causes included vascular disease (21.1%), diabetic neuropathy (17.1%), and nondiabetic neuropathy (10.5%).
Reversible causes like psychogenic factors or hypogonadism were identified in 15.7%, and treatable conditions like penile neuropathy in 31.5%.

Conclusions:

Geriatric erectile impotence is predominantly linked to vascular or neurologic dysfunction.
A significant proportion of aged men with impotence may have reversible or treatable conditions, emphasizing the importance of diagnostic workup.