Cystometry and mictometry as tools in diagnosing neurogenic impotence.
Thirty-six males with erective impotence underwent neurological and urological examinations. Six of the patients were known to have a neurological disorder at the time of referral (four multiple sclerosis, one myelomeningocele, one diabetic polyneuropathy). Four further cases of neurological disorders were found (one multiple sclerosis, one myelopathy of unknown cause, one Shy-Drager syndrome, one sequelae of sacral herpes zoster). Five of these 10 patients gave a history of urinary troubles, but in all of them objective signs of bladder dysfunction were found at cystometry and/or mictometry. Among the 26 patients with impotence and no indication of a neurological disorder all invariably had normal cystometrograms, though some had abnormal mictiograms, probably due to local urological disorders. A neurological examination should be included in the evaluation of patients with erective impotence. Cystometry and mictometry may be of value by giving additional indications that the impotence is neurogenic. This is explained by the fact that the anatomical structures regulating sexual function lie close to corresponding structures regulating bladder function at the spinal level.