Vascular factor in erectile failure among diabetics.
Clinical, sexual, and laboratory evaluations were made on 47 impotent diabetics. All patients were given a Doppler PAPS examination and a neurologic assessment of the penis (BCRL and/or CMG). Nerve conductivity tests of the legs were also administered to most patients. The groups were classified as to whether they were insulin or noninsulin dependent. Abnormalities of penile arterial flow were detected in 95.7 per cent of all the patients. Penile arterial occlusions without associated penile neuropathies occurred in 61.7 per cent. Penile neuropathies were found in 34 per cent, and all were associated with varying degrees of penile arterial obstruction. Diabetics who were dependent on insulin showed a high frequency of vascular pathologies and a 12 to 15 per cent higher rate of penile neuropathies than the group not dependent on insulin. Our study suggests that obstruction of penile arteries is the primary factor in erectile dysfunction of diabetics. Those impotent diabetics without any overt penile nerve damage might be good candidates for revascularization procedures.