Name of the Procedure:

Penile Plethysmography
Common name(s): PPG, Phallometric Testing

Summary

Penile plethysmography (PPG) is a diagnostic test that measures blood flow and changes in the size of the penis. It is primarily used to assess erectile function and determine the causes of erectile dysfunction.

Purpose

Penile plethysmography is used to:

• Evaluate erectile dysfunction (ED)
• Diagnose psychological vs. physiological causes of ED
• Aid in the assessment of sexual arousal patterns

The goal is to determine the underlying cause of erectile dysfunction, which can inform treatment options and improve sexual health.

Indications

• Persistent erectile dysfunction
• Suspected psychogenic or organic causes of ED
• Monitoring treatment efficacy for erectile issues
• Legal cases involving sexual offenses (assessment of sexual arousal patterns)

Preparation

• No specific fasting or dietary restrictions.
• Patients may be advised to avoid certain medications that could affect blood flow or sexual response.
• A thorough medical and sexual history is typically taken beforehand.

Procedure Description

1. The patient is seated comfortably in a private room.
2. A band (strain gauge or other sensing device) is placed around the penis.
3. The patient may be exposed to various stimuli (visual or auditory) intended to elicit a sexual response.
4. The plethysmograph records changes in penile circumference or volume, which are then analyzed.

Tools/Equipment: Strain gauges, plethysmograph machine, audiovisual stimuli.

Anesthesia/Sedation: None required; the procedure is non-invasive and typically painless.

Duration

The procedure typically takes between 30 to 60 minutes.

Setting

Penile plethysmography is usually performed in a specialized outpatient clinic or diagnostic center.

Personnel

• Trained urologist or sexologist
• Clinical technician or nurse

Risks and Complications

Common Risks:

• Mild discomfort or embarrassment
• Anxiety

Rare Risks:

• None significant, as the procedure is non-invasive

Possible Complications:

• Increased anxiety related to sexual performance

Benefits

• Accurate assessment of erectile dysfunction causes
• Tailored treatment plans based on the results
• Improved understanding of sexual health issues

Realization of Benefits: Typically immediate, as the results can quickly inform treatment decisions.

Recovery

• No physical recovery needed.
• Post-procedure counseling may be recommended to address any emotional or psychological concerns.

Alternatives

• Nocturnal penile tumescence (NPT) testing
• Doppler ultrasound of penile blood flow
• Psychological evaluation and therapy

Pros of Alternatives:

• Less invasive (NPT)
• Detailed blood flow imaging (Doppler ultrasound)

Cons of Alternatives:

• May not directly measure arousal response
• May require multiple sessions or additional imaging

Patient Experience

During the procedure, patients might feel slight discomfort due to the band around the penis but no pain. Some individuals may experience anxiety or embarrassment, and open communication with healthcare providers can help manage these feelings.