L'insuffisance veino-caverneuse n'est-elle pas la seule cause de dysérection organique ?

: Organic causes for impotence are rarely detected because of the inadequate investigation of the patients. The assessment of impotence must include clinical examination (principally interview) and complementary investigations. The clinical history is strongly suggestive of an organic cause. Organic investigation must be proposed to these patients when they are motivated and occasionally in obviously "psychological" patients in order to reassure him that all of the organic factors "function correctly". The complementary investigations are as follows: hormonal survey (testosterone, prolactin), nocturnal penile plethysmography, penile arterial Doppler, EMG of the bulbocavernosus muscles and the papaverine test (30 mg or 60 mg). When the papaverine test is abnormal, cavernometry should be proposed. In conclusion, supportive sex therapy is often essential and a penile prosthesis should only be proposed as a last resort, when treatments adapted to the cause have failed.