Arterial disease as a cause of impotence.

The traditional views on the aetiology of impotence, attributing more than 90 per cent of all cases of impotence to psychic pathogenesis, have changed. Measurement of penile blood pressure, nocturnal penile tumescence studies (NPT) and especially new techniques of arteriographic examination of the arterial bed supplying the cavernous bodies have shown that the majority of cases have an organic basis affecting the haemodynamics of erection (limitation of arterial inflow into the cavernous bodies and/or their excessive venous drainage). Arterial disease, which is the most frequent affection in the middle-aged and elderly male population, is also largely implicated in the pathogenesis and aetiology of impotence. Recognition of this role of arterial disease is important not only with respect to the treatment of impotence but above all with respect to prevention of even more serious complications of the former condition such as IHD and MI, cerebrovascular disease and stroke, or intermittent claudication and gangrene.