Autonomic nerve involvement and venous leakage in diabetic men with impotence

Objective To determine the neurophysiological and vascular factors in diabe tic impotence, particularly the role of autonomic neuropathy on venous leak age and erectile impotence. Patients and methods Thirty-four diabetic men with impotence were investiga ted using Various neurophysiological and radiological methods, The results were compared with those from patients with idiopathic penile Venous leakag e for autonomic neuropathy, especially for spontaneous cavernosal activity (SCA). Results Of the neurophysiological tests, the SCA was most frequently abnorm al, with the loss of normal periodic oscillations, Penile venous leakage, e ither alone or with arterial insufficiency, was the most frequent vascular problem (67%) in patients with diabetic impotence, in whom the SCA was abse nt in most (83%). Conversely, the SCA was normal in all impotent patients w ith idiopathic venous leakage. Conclusion Venous leakage in diabetic patients is probably produced by auto nomic dysfunction of the penile vascular innervation or degeneration of pen ile smooth muscles, because the SCA was absent more often in these patients .