Nocturnal penile tumescence and/or rigidity test
CPT4 code
Name of the Procedure:
Nocturnal Penile Tumescence (NPT) Test, also known as a nocturnal erection test or rigidity test.
Summary
The Nocturnal Penile Tumescence (NPT) test is a procedure to monitor and measure the number of erections, their rigidity, and duration during sleep. It helps in diagnosing erectile dysfunction (ED) to determine if the cause is physical or psychological.
Purpose
The NPT test addresses erectile dysfunction by assessing whether a man has normal erections during sleep, suggesting a psychological cause if nocturnal erections are present, or a physical cause if they are absent. The goal is to accurately diagnose the cause of ED to guide appropriate treatment.
Indications
- Persistent erectile dysfunction.
- Inability to achieve or maintain an erection sufficient for sexual intercourse.
- Differentiating between physical and psychological causes of ED.
Preparation
- No specific fasting or medication adjustments are usually required.
- Patients should inform their doctor of any medications they are taking.
- An overnight stay in a sleep lab might be required.
Procedure Description
- The patient is fitted with a device called a RigiScan or a similar monitor, which is worn around the penis during sleep.
- The device measures and records the number of erections, their rigidity, duration, and other relevant data.
- The patient sleeps with the device overnight, typically in a sleep lab for accurate monitoring.
Duration
The setup process takes about 15-30 minutes, and the monitoring occurs overnight.
Setting
The procedure is typically performed in a sleep lab or hospital setting with specialized equipment.
Personnel
- Sleep technicians or nurses to attach the device and oversee the monitoring process.
- Physicians to interpret the results.
Risks and Complications
- Generally considered safe with minimal risk.
- Possible discomfort from wearing the device.
Benefits
- Provides valuable diagnostic information to determine the cause of erectile dysfunction.
- Non-invasive with high diagnostic accuracy.
- Results are usually analyzed and available within a few days after the test.
Recovery
- No recovery time as the procedure is non-invasive.
- Patients can resume normal activities immediately after the test.
Alternatives
- Psychological assessment and therapy.
- Hormone level testing.
- Doppler ultrasound of the penile arteries.
Pros and cons of alternatives:
- Psychological therapy can address non-physical causes but does not diagnose physiological issues.
- Hormone level testing targets hormonal imbalances but might not detect other physical causes.
- Doppler ultrasound visualizes blood flow but requires specialized equipment and interpretation.
Patient Experience
- The patient might feel some initial discomfort while getting used to the device.
- During the test, the patient should try to sleep normally.
- Post-procedure, some mild irritation or disrupted sleep might be experienced, but pain is unlikely. Pain management and comfort measures are usually not required.