https://doi.org/10.4081/aiua.2025.14069
Nocturnal penile tumescence test, revaluation of its utility after 1587 exams recorded from 1986 to 2024
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Published: 28 July 2025
Introduction: The Authors report their 38-year experience with the use of nocturnal penile tumescence (NPT) testing.
Methods: Among over 46,000 patients evaluated for andrological issues since 1980, the NPT test was selectively proposed in cases of suspected psychogenic erectile dysfunction, as part of a standardized diagnostic workup, which included medical history, physical and genital examination, blood tests, and hormonal evaluation. The test aimed to assess nocturnal erectile function and support differential diagnosis.
Results: From June 20, 1986, to December 31, 2024, a total of 1,587 NPT recordings were performed in patients aged 16 to 90 years. Among these, 992 tests were conducted over three nights, 486 over two nights, and 109 for a single night. The majority of tests were completed without major issues and provided interpretable data. Overall, the test was well tolerated, with good patient compliance and minimal technical difficulties. In many cases, the recordings allowed useful diagnostic insights into the nature of erectile dysfunction. In nearly all cases, patients exhibited varying degrees of anxiety concerning their ED, often interpreted as a consequence rather than the cause of an underlying organic condition.
Conclusions: After nearly four decades of clinical use, NPT testing has proven to be a reliable and informative component of the diagnostic approach to erectile dysfunction. Its ability to offer objective data in a home setting, with minimal discomfort and high patient compliance, makes it a useful adjunct in distinguishing psychogenic from etiologies.
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Karacan I, Salis PJ, Williams RL. Clinical disorders of sleep. Psychosomatics. 1973; 14:77-88. DOI: https://doi.org/10.1016/S0033-3182(73)71360-8
Karacan I, Williams RL, Thornby JI, Salis PJ. Sleep-related penile tumescence as a function of age. Am J Psychiatry. 1975; 132:932-7. DOI: https://doi.org/10.1176/ajp.132.9.932
Beutler LE, Scott FB, Karacan I. Psychological screening of impotent men. J Urol. 1976;116:163-71. DOI: https://doi.org/10.1016/S0022-5347(17)58742-X
Karacan I, Aslan C, Hirshkowitz M. Erectile mechanism in man. Science, 1983; 220:1080-2. DOI: https://doi.org/10.1126/science.6844930
Timm GW. The performance of the Rigiscan in the measurement of penile tumescence and rigidity. Int J Impot Res 1994; 6:43-6.
Bradley W, Timm G, Gallagher J, Johnson B. New method for continuous measurement of nocturnal penile tumescence and rigidity. Urology. 1985; 26:4-9. DOI: https://doi.org/10.1016/0090-4295(85)90243-2
Dacomed Corporation, Minneapolis, Minnesota, USA (1986). Ambulatory rigidity and tumescence system. Selected Cases studies. Farm number 7501560486.
Levine LA, Lenting EI. Use of nocturnal penile tumescence and rigidity in the evaluation of male erectile dysfunction. Urol Clin North Am. 1995; 22:755-8.
Giesbers AAGM, Bruinss JK, Kramer AEJL, Jonas U, New Method in the diagnosis of impotence: Rigiscan penile tumescence and rigidity monitoring and diagnostic papaverindehydrochloride injection. World J Urol. 1987; 5:173-6. DOI: https://doi.org/10.1007/BF00326827
Pozza D, Ossanna P, Marchionni L. Can Rigiscan nocturnal monitoring reveal the etiology of organic impotence?. Int J Impot Res. 1990; 21; 105-6.
Cilurzo P, Canale D, Turchi P, et al. The Rigiscan system in the diagnosis of male sexual impotence. Arch Ital Urol Nefrol Androl. 1992;64:S81-5.
Karacan I, Karatas M. Erectile dysfunction in sleep apnea and response to CPAP. J Sex Marital Ther. 1995; 21:239-47. DOI: https://doi.org/10.1080/00926239508414643
Nehra A, Goldstein I, Pabby A, et al. Mechanisms of venous leakage: a prospective clinicopathological correlation of corporeal function and structure. J Urol. 1996; 156:1320-9. DOI: https://doi.org/10.1016/S0022-5347(01)65578-2
Pozza D, Ossanna P, Marchionni. Nocturnal and real-time Rigiscan monitoring in patients with venous incompetence. Arch Esp Urol. 1996; 49:217-20.
Martins FE, Reis JP. Visual erotic stimulation test for initial screening of psychigenuc erectile dysfunction: a reliable noninvasive alternative? J Urol. 1997; 157:134-9 DOI: https://doi.org/10.1016/S0022-5347(01)65306-0
Djamilian M, Stief CG, Hartmann U, Jonas U. Predictive value of real-time RigiScan monitoring for the etiology of organogenic impotence. J Urol. 1993; 149:1269-71. DOI: https://doi.org/10.1016/S0022-5347(17)36364-4
Yannakoyorgos K, Dimitriadis G, Kalinderis A. Nocturnal penile tumescence and rigidity monitoring in young potent volunteers: reproducibility, evaluation criteria and the effect of sexual intercourse. J Urol. 1998; 159:1921-6. DOI: https://doi.org/10.1016/S0022-5347(01)63197-5
Jannini EA, Granata AM, Hatzimouratidis K, Goldstein I. Use and abuse of RigiScan in the diagnosis of erectile dysfunction. J Sex Med. 2009; 6:1820-9. DOI: https://doi.org/10.1111/j.1743-6109.2009.01343.x
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