Practical diagnostic screening for impotence

The author presents the view that there is a real need to diagnose impotence in more detail as demand for physiologic solutions to erectile dysfunction make inroads into the simplistic solution offered by penile implantation. Penile blood pressure measurements are diagnostic of vascular insufficiency only when values are low, since it is possible to demonstrate obstructive disease of the internal pudendal artery and its branches with selective arteriography of the presence of normal penile blood pressure. A rational approach to the workup of impotence is called for and practitioners are asked to weigh the ultimate usefulness of each test in the context of the individual patient's needs.