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Abnormal endothelial function in ED patients with normal nocturnal penile tumescence and rigidity: is it the role of psychogenic factors?


Underlying endothelial dysfunction (EnD) may present in the early stage of ED or psychogenic ED. We retrospectively evaluated 191 ED patients with effective nocturnal penile tumescence and rigidity (NPTR) recording, including detailed medical and psychosexual history, International Index of Erectile Function-5 and vascular parameter. All patients were allocated into psychogenic and organic groups according to the NPTR test. Brachial artery flow-mediated dilation (FMD) was used to diagnose EnD, and ED patients were classified into two groups: non-EnD (FMD10) and EnD (FMD<10). General and vascular parameters were compared between psychogenic and organic groups, and non-EnD and EnD groups with ED were compared in terms of NPTR parameters. In all, 48.7% and 51.3% patients were diagnosed as psychogenic and organic ED, respectively. 73.1% of the psychogenic patients had EnD and 39.8% organic patients had normal endothelial function. In all parameters, only the FMD value showed significant difference between psychogenic and organic ED groups (8.26±2.57 vs 9.16±2.76, P=0.020). No statistical difference was founded in NPTR parameters between non-EnD and EnD groups (P>0.05). In conclusion, NPTR cannot effectively identify the underlying vasculogenic ED from psychogenic ED. Psychogenic causes may cause or aggravate EnD in these ED patients with normal NPTR.

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We thank Professor Yuan-yuan Zhang and Ching-Shwun Lin for the great efforts on revising the manuscript. This study was supported by the grant of National Natural Science Foundation of China (30872571, 81070488, Professor Deng received a grant from NSFC; 30901487, Professor Sun received a grant from NSFC), Guangdong Natural Science Fund (07001628, 10251008901000005, Professor Deng received a grant from GDNSFC; 8451008901000774, Professor Sun received a grant from GDNSFC; 10151008901000222, Dr Deng received a grant from GDNSFC); Guangdong Province Science and Technology Project (2011B031800115, Professor Deng received a grant from GDSTC; 2008B080703056, Professor Liu received a grant from GDSTC; 2009B030801178, Dr Deng received a grant from GDSTC) the grant of Research Fund for the Doctoral Program of Higher Education of China (20100171110060, Professor Deng received a grant from RFDP).

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Correspondence to X-Z Sun or C-H Deng.

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Huang, YP., Zhang, YD., Gao, Y. et al. Abnormal endothelial function in ED patients with normal nocturnal penile tumescence and rigidity: is it the role of psychogenic factors?. Int J Impot Res 24, 247–250 (2012).

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  • ED
  • endothelial dysfunction
  • flow-mediated dilation
  • nocturnal penile tumescence and rigidity
  • organic
  • psychogenic


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