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Difficulties in achieving vs maintaining erection: organic, psychogenic and relational determinants


Achieving and maintaining a penile erection are two essential components of the male sexual response. It has recently been suggested that distinct molecular mechanism could underlie the two disturbances. The aim of the present study is to verify possible clinical differences on pathogenetic factors underlying difficulties of achieving and maintaining an erection. We studied a consecutive series of 560 patients (aged 51.9±12.8 y old) reporting erectile dysfunction (ED), using SIEDY© structured interview. Patients were classified into two distinct categories: those with difficulties in maintaining, rather than achieving, an erection (sample A) and those with main problems in achieving an erection (sample B). A complete physical examination and a series of metabolic, biochemical, hormonal, psychometric, penile vascular tests and nocturnal penile tumescence and rigidity evaluations (NPT) were also performed. Sample B patients showed a higher prevalence of organic conditions related to ED, when compared with sample A as confirmed by higher SIEDY© scale 1 scores (3[1–5] vs 1[0.1–3] for sample B vs sample A, respectively; P<0.0001) which explores organic component of ED and higher prevalence of pathological instrumental parameters. No difference among groups was observed for SIEDY© scale 2 (relational component) and SIEDY© scale 3 (intrapsychic component) of ED. In conclusion, this study shows for the first time that patients with difficulties in maintaining erection are less likely to be affected by organic disturbances interfering with sexual function, when compared with those unable to achieve a valid erection.

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We thank Angela Magini, Antonio Cilotti, Andrology Unit of the University of Florence, Marco Bartolini, Radiology Unit of the University of Florence and Valerio Chiarini and Alessandra Sforza, Endocrinology Unit of Maggiore-Bellaria Hospital, Bologna, for their helpful clinical collaboration during the course of the study. This study was partially supported by a grant from, Eli Lilly & Co, Sesto Fiorentino, Florence, Italy, and from Centro di Ricerca Trasferimento ed Alta Formazione MCIDNENT of the University of Florence.

Note: a patent is pending on the use of SIEDY©.

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Correspondence to M Maggi.

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Corona, G., Petrone, L., Mannucci, E. et al. Difficulties in achieving vs maintaining erection: organic, psychogenic and relational determinants. Int J Impot Res 17, 252–258 (2005).

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  • erectile dysfunction
  • SIEDY©
  • structured interview

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