Penile sympathetic skin response in patients with non-organic erectile dysfunction: a Cross-Sectional Study

This study evaluated the clinical value of penile sympathetic skin response (PSSR) in patients with non-organic erectile dysfunction (ED) and its correlation with psychological status. Based on the results of the nocturnal penile tumescence and rigidity (NPTR) test, the study included 68 patients with non-organic ED, 30 patients with organic ED, and 120 matched control subjects with normal erectile function. All subjects underwent PSSR testing to measure PSSR latency, International Index of Erectile Function-5 (IIEF-5) scores, and self-rating anxiety scale (SAS) scores. The results showed that the PSSR latency in patients with non-organic ED was significantly shorter than that in patients with organic ED and normal controls (NCs) (1179.12 ± 145.38 vs. 1420.00 ± 145.97 vs. 1382.00 ± 179.68 ms, p < 0.001). Furthermore, PSSR latency in patients with non-organic ED was negatively correlated with the SAS anxiety score (p < 0.001, r = -0.681) and positively correlated with the IIEF-5 score (p < 0.001, r = 0.493). Our study results suggest that patients with non-organic ED have excessive sympathetic excitation, and PSSR can be used as an objective electrophysiological indicator to assess autonomic nerve dysfunction, providing a rapid, non-invasive auxiliary tool for clinical differential diagnosis. This study is the first to reveal a significant association between PSSR latency and psychological anxiety, suggesting that enhanced sympathetic nerve activity may be an important pathological mechanism of non-organic ED.