Comparative investigations in 26 impotent and 26 nonimpotent diabetic patients

To determine the causes of diabetic impotence the same investigations were performed in 26 impotent and 26 nonimpotent diabetics. The rates of abnormalities found were almost identical in the 2 groups in regard to Doppler examination of the penile arteries, conduction velocities of the median nerves, latency times of the bulbocavernosus reflex and cystometrograms. Conversely, urine flow rates (24 of 25 versus 2 of 26 patients) and Minnesota Multiphasic Personality Inventory (14 of 23 versus 0 of 14 patients) were almost exclusively abnormal in the impotent diabetics. In addition, inadequate sex-specific attitudes were found in 60 per cent of the impotent diabetic men, which was the proportion found in a carefully selected sample of psychogenically impotent nondiabetic men. The distribution of the abnormalities found suggests that in most diabetic patients impotence results from the addition of a subtle abnormality of the autonomic nervous system in almost every case or psychological and arterial factors.