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Both RigiScan and the Snap Gauge band devices are used to objectively measure penile rigidity. The Snap Gauge band is the more simple and inexpensive of the two techniques. We investigated the correlation between the results obtained by both devices in order to evaluate whether the Snap Gauge band could be employed as the sole method of rigidity ev...
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Erection measurements are the most important indicator of male urological disease diagnosis, treatment, and results. Rigiscan has been used widely in studies and diagnoses for nocturnal penile tumescence for evaluating erectile dysfunction by measuring the number and timing of erectile dysfunctions during sleep. However, this device has limitations...
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... Furthermore, when compared with the RigiScan (Timm Medical Technologies Inc, Minneapolis, MN, USA. RigiScan was first introduced in 1985 and its main characteristics were shown in Table 1), which is currently regarded as the most effective measurement, the Snap gauge band provided a significantly cheaper and relatively reliable (sensitivity of 100% and specificity of 75%) approach for ED assessment [47,48]. These advantages promoted its clinical application [49][50][51]. ...
Over the past decades, sleep-related erection and rigidity monitoring has been used to differentiate psychogenic from organic erectile dysfunction (ED), due to the involuntary nature of erections in sleep. This study retrospectively reviewed all available literature focusing on sleep-related erection and rigidity monitoring through a systematic PubMed search. To date, there are mainly seven methods and their modifications, including: sleep laboratory testing, the mercury strain gauge, the stamp test, the erectometer, the Snap gauge, the RigiScan, and nocturnal electrobioimpedance volumetric assessment. This study analyzes and summarizes the advantages and limitations of seven monitoring methods. This study indicates that both of the above methods possess the capacity to assess erectile quality and provide guidance to the diagnosis, etiology, and differential diagnosis of ED. However, some limitations still exist for the application. New devices which can continuously monitor kinds of variables, including sleep-related erection, axial and radial rigidity, and oxygen saturation are needed.
... In a recent report, the snap gauge band showed 73% and 89% positive and negative predictive values, respectively, for penile rigidity determined by the RigiScan, although there was no information concerning sensitivity or specificity. 19,20 These data were similar to our predictive values. Thus, the circumferential changes measured by the erectometer may be as useful as other devices at predicting penile capacity or differentiating between an organic etiology of ED and a psychological one. ...
... Thus, the circumferential changes measured by the erectometer may be as useful as other devices at predicting penile capacity or differentiating between an organic etiology of ED and a psychological one. 8,9,20 A 'patient's goal directed method' must be considered in ED examination. 21 Currently, most ED patients prefer oral therapy (i.e. ...
The goal of this study was to evaluate the correlation between increments of penile tumescence and penile rigidity measured by the erectometer and the RigiScan, respectively.
Nocturnal penile tumescence (NPT) was measured in 25 volunteers (mean age, 49.5 years). The erectometer and the RigiScan were used simultaneously for a total of 47 nights. We studied the correlation between maximum penile circumferential changes determined by the erectometer and penile rigidity patterns measured by the RigiScan.
Maximum circumferential changes during NPT measured by the erectometer were well correlated to those determined by the RigiScan (correlation coefficient, 0.719). In addition, penile circumferential changes measured by the erectometer corresponded well to the penile rigidity pattern determined by the RigiScan (P = 0.0001). Specifically, maximum penile circumferential changes of more than 30 mm and less than 10 mm had 70% positive predictive value and 100% negative predictive value for predicting the normal rigidity pattern, respectively.
Penile circumferential changes measured by the erectometer were well correlated to penile rigidity measured by the RigiScan, particularly when the increments were larger than 30 mm or less than 10 mm. These results suggested that the erectometer was a useful tool to estimate the penile rigidity patterns of the RigiScan.
This chapter discusses the techniques for the assessment of sleep-related erections. Nocturnal penile tumescence (NPT) is a cyclic pattern of penile erections that occur in virtually all sexually potent men. More accurately called sleep-related erections, this naturally occurring cycle provides a measurable phenomenon for objectively indexing erectile function. The erections normally occur in close coordination with rapid eye movement (REM) sleep. The traditional technique for evaluating sleep-related erections includes recording electroencephalographic (EEG) and electrooculographic (EOG) activity in conjunction with penile circumference increase. Tracings are scored for sleep stages and wakefulness. The standard laboratory approach to recording penile circumference increase involves placing a mercury-filled strain gauge around the penis. During an erection, the column of mercury elongates and the tubing narrows, thus increasing the gauge's electrical resistance. Electrical resistance is transduced to direct current voltage by a bridge amplifier. The bridge amplifier output, when connected to the polygraph pen driver input, provides a continuous tracing of circumference change.
Introduction:
The Erection Hardness Score (EHS) and the Sexual Health Inventory for men (SHIM) are patient-reported outcome scoring systems for erectile function. It is unclear which is more reliable for predicting the objective erectile function.
Aim:
The aim of this study was to evaluate whether the EHS could predict objective erectile function by measuring the maximal penile circumferential change (MPCC) with an erectometer.
Methods:
The study included 98 patients who visited our clinic from 2005 to 2010. The erectile function was evaluated using the SHIM, EHS, and MPCC. The MPCC was measured with the largest circumferential change of three consecutive occurrences of nocturnal penile tumescence (NPT) determined using the erectometer.
Main outcome measures:
We defined erectile dysfunction (ED) as MPCC < 20 mm and carried out multivariate analysis using logistic regression analysis to clarify the predictors for ED, with the variables including age, the SHIM score, and the EHS. We compared the tendency for MPCC ≥ 20 mm when EHS was 3 or more with that when EHS was 2 or less.
Results:
The median age of the patients was 59.5 years (range 18-83). In logistic regression analysis, the EHS was the only predictor for ED with MPCC < 20 mm. The mean EHS in the MPCC < 20 mm group was 1.64 ± 0.20 (mean ± SEM) and that in the MPCC ≥ 20 mm group was 2.46 ± 0.13 (P = 0.0018). There was a correlation between the EHS and the MPCC (correlation coefficient = 0.33). In comparison with the group having an EHS of 2 or less, that with an EHS of 3 or more tended to have MPCC ≥ 20 mm (P = 0.013).
Conclusions:
The EHS was correlated with the MPCC. The EHS represents the objective erectile function shown by the measurement of NPT.
This Letter shows the equivalence of the velocity-level and acceleration-level redundancy resolution schemes by using so-called Zhang et al.ʼs neural-dynamic method. In addition, the equivalence requires that a design parameter be sufficiently large. But how large should it be? The effective range of such a design parameter is thus determined by means of the 2%-difference rule and the runtime of the computer-simulations.
This chapter discusses the historical background, technical considerations, and clinical indications of sleep-related erections. Penile erections are a naturally occurring phenomenon during rapid eye movement (REM) sleep in all males from infancy to the elderly. Similar clitoral erections and vaginal engorgement also occurs in females during REM sleep. This strong temporal association between REM sleep and erectile activity allows for clinical evaluation of erectile function in males experiencing erectile dysfunction. A major advantage of sleep-related erection (SRE) testing is that the erection occurs during a stimulus—that is, REM sleep, which is minimally influenced by psychological factors. There are 4–5 cyclically occurring REM periods during a typical night's sleep, lasting 15–25 minutes each in duration. REM sleep thus provides approximately 2 hours of total erection time during any given night's sleep. If properly performed, an objective monitoring of these REM-related erections can provide tremendous clinical information regarding an individual's underlying erectile capability.
Introduction. Nocturnal penile tumescence and rigidity (NPTR, or, more simply, NPT) studies, with or without the help of a recording computer (Rigiscan), have been traditionally positioned at the head of several erectile dysfunction (ED) diagnostic flowcharts with the aim to distinguish between psychogenic and organic etiology. Shall we continue to consider these tools as a diagnostic gold standard in ED diagnosis?
Methods. Four scientists with expertise and/or interest in the area of ED pathophysiology and diagnosis were asked to contribute their opinions.
Main Outcome Measure. To give to The Journal of Sexual Medicine's reader new stimuli to reexamine a still largely utilized tool utilized in sexual medicine's clinical practice.
Results. Of the four experts discussing the topic, the first who is the section editor of the Controversy section, believes that NPT/Rigiscan cannot be considered a useful diagnostic tool for differential diagnosis in ED. He is supported by the physiological considerations of the second expert and by the experimental evidence produced and discussed by the expert number four who questions the accuracy, reliability, and usefulness of these tools to measure a critical aspect of the erection physiology which is the adequate rigidity. In contrast, with several good arguments, the third expert still suggests the use of these tools, perhaps not for every man presenting with ED, but at least for the patient with no neurovascular risk factors who presents with a history suggestive of a psychogenic cause.
Conclusion. The reader will judge if the expensive, complicated, and time-consuming effort to record nocturnal erectile activity is or is not useful anymore for the patient and for orienting the treatment choices. Jannini EA, Granata AM, Hatzimouratidis K, and Goldstein I. Use and abuse of rigiscan in the diagnosis of erectile dysfunction. J Sex Med 2009;6:1820–1829.
This article describes and evaluates critically the outcome measures available for the assessment of the conservative treatment of erectile dysfunction (ED). The literature review identified 26 outcome measures. Of these, 14 were subjective and 12 were objective. Objective measures can provide more accurate information. However, owing to the sensitive nature of the problem, questionnaires which are reliable and sensitive to change can provide valuable data. Different outcome measures were needed for each of the separate components of ED. These components were found to be rigidity, vascular flow, nerve conductivity, intracavemosal pressure, ischiocavernosus muscle power, partner satisfaction and quality of life. An evaluation of outcome measures for each component of ED is provided in the second part of this article. Quick, simple, inexpensive and efficient outcome measures can be used by nurses to evaluate the impact of conservative treatment for ED.
The aim of this prospective study was to examine the ability of the Snap-Gauge band to differentiate organic from psychogenic erectile dysfunction (ED).
Nocturnal penile tumescence testing was performed on 12 patients using a Snap-Gauge band and RigiScan Plus. A total of 29 nightly examinations were evaluated. The results obtained with the two methods were compared.
The average tumescence, average rigidity, tumescence activity units and rigidity activity units in the positive group (the group of cases in which one, two or three films of the Snap-Gauge band were broken) were each significantly greater than that in the negative group (the group of cases in which no film was broken). The Snap-Gauge band correctly diagnosed 90% of the patients with a sensitivity of 100% and specificity of 75% with respect to results obtained using the RigiScan Plus.
The Snap-Gauge band is inexpensive compared to the RigiScan Plus and is relatively reliable. We conclude that the Snap-Gauge band can play a role in ED assessment and can function as a screening device in evaluation of ED.
We questioned the need for more than one RigiScan recording for accurate assessment of sleep-associated penile erections and determine the necessity of consecutive nightly recordings for valid evaluation of sleep-associated erections. Men complaining of erectile dysfunction (ED) and referred to RigiScan evaluation for the first time participated. Recordings were performed at the patient's home during two consecutive nights, and data on test time, number of erections, erection duration, minimal and maximal base and tip tumescence and rigidity were retrieved for both nights. Normal erectile function was defined with the recording of at least one erection (70 out of 100% tip rigidity lasting for at least 10 min during either night). The main outcome measures were RigiScan recordings. Group 1 consisted of 29 men (mean age 42.4+/-13.8 years, range 22-71) who had normal erections, all during the first night. Group 2 consisted of 26 men (mean age 48.6+/-13.5 years, range 25-70) who failed to fulfill both criteria for normal erection. In Group 2, only the values for penile base rigidity and erection duration were normal during the first night: the parameters of maximal base tumescence, tip rigidity, number of effective erections and duration of effective erections that were impaired during the first night were significantly worse (P<0.01) during the second night. The required information for the diagnosis of psychogenic ED was obtained during the first night in >50% of the participants. Men with normal erections during the first night can be spared the inconvenience and cost of re-testing. Consecutive night recording should be reserved for patients whose recorded data during the first night did not fulfill the criteria for normal erection.
