• Diagnostic Methods

To a perfect diagnostic of the problem's cause of impotence, there are the following exams in disposition. They are very simple exams, but fundamental for an evaluation of the case. After a detailed discussion with the patient and a good anamnesis, the doctor shall proceed the physical exam, and, if there's the need, use some laboratorial exams where it will be possible to evaluate the many factors such as blood sugar, hormone levels, etc.
After this step, it might be necessary many exams which are listed below:

Doppler e Color Penile Doppler

Supplies information about the penis' hemodynamic, after the relaxation of the smooth muscle induced with a vasoactive agent. The goal is to distinguish the arterial insufficiency with other causes of the erectile disorder. The blood speed in the carvenosa artery might be measured and then, distinguished the physical impotence of psychogenic.

Above color Doppler image of a normal penile artery and in the image below a color Doppler of an artery showing reduced flow.

Exam of Induced-Erection (TEFI) Tests with Prostaglandin

This test has the goal of promoting erection through an intrusiveness injection of vasoactive drugs that promote the smooth muscles relaxing and the corpora carvenosa.
Its accomplishment is recommended to carriers of Erectile Dysfunction (ED), except the individuals clearly psychogenic characterized by: selectiveness of partners, normal erections in situations, etc. In these cases, the TEFI might be done when there's the need to confirm the erectile capacity of the patient. TEFI is also recommend for the evaluation of penile curvatures.
A positive result does not eliminate the possibility of being some problem of vascular and/or cavernosa order, but it shows that when stimulated the penis can obtain an erection. This result opens more options for treatment which is the application of intravenous injections.

Penile Ultrasonography

It is a totally not invasive exam that allows to check the penis' morphology and if the patient shows Peronei, or Peronei’s Plaque.

Test of Nocturnal Penile Tumescence (NPT)

The presence of a nocturnal erection, which is used to distinguish organic psychogenic impotence, may be detected by using devices that are put around the penis during the sleep. The apparatus is projected to record the nocturnal erection occurrence. The determination of the erection's presence or absence may help in the conduct for the treatment to be used.