Significance of Polysomnographic Nocturnal Penile Tumescence Monitoring in the Diagnosis of Erectile Impotence

Suh, Jun Kyu; Oh, Tae Hee; Park, Tong Choon

Abstract

Nocturnal penile tumescence has been proposed as a source of objective data in the evaluation of erectile capacity and clinically important in differentiating between psychogenic and organic impotence. However, the absence of sleep information and difficult differentiation of movement artifact leads to false positive or false negative reaction when portable home monitor is used. This can be overcome by polysomnographic monitoring. In addition, sleep disorders affecting nocturnal penile tumescence also could be screened. Herein, we conducted a study to investigate the significance of polysomnographic nocturnal penile tumescence monitoring in 45 men with erectile dysfunction. The nocturnal penile tumescence data from polysomnographic method were compared with those from portable method, based on the results from standard method. The results obtained were summarized 1. Polysomnographic method showed higher sensitivity(82%), lower false positive(20%) and false negative rate(16%) than portable method (71%, 30%, 28%, respectively) in the differential diagnosis of impotence. 2. Among 10 patients, with measuring of air flow monitoring and anterior tibialis EMG one patient had periodic leg movement. 3. Statistically, parameters of total REM time, total tumescence time/total sleep time, number of maximum tumescence episodes, amount of maximum tumescence episodes, T-up and T-max phase in maximum tumescence episodes, circumferential changes in maximum tumescence episodes, and rigidity in maximum tumescence episodes were found to be significantly decreased in organic impotence group. These results reflect that polysomnographic NPTM provides more validity than portable NPTM on the outcome of the differential diagnosis of impotence, and it would contribute to screening of occult sleep disorders and to study for their characteristics in association with impotence.