Dr. Urspo, on his blog, recently mentioned a couple of
objects found in his office desk drawer which may have been used as a method of
explaining how to use them. The objects were a cock ring and a condom. This
triggered a memory of erectile dysfunction testing as a part of sleep disorders
testing. In the old days before Viagra and Cialis, Medicare, Workmen’s
Compensation, and some other insurance companies would pay for devices to treat
male impotence. However, they needed to establish that the man was not capable
of getting an erection.
All males from infancy to old age get penile erections
during REM sleep. If a man has erections during REM sleep, then he should be
able to get erections while awake as well. If he can get erections during REM
sleep, but could not get erections during sexual arousal, it was considered to
be a psychological problem. However, if he did not get erections during REM
sleep, the lack of erections was considered physiological, such as a result of
diabetes or injury, etc.
An early method was to use a strip of postage stamps. The
denomination of the stamps was of no use and therefore one would use one cent
stamps. One would wrap a long enough strip of the stamps around the flaccid
penis to connect them at bedtime. No jokes, now, about who would lick the stamps.
If the subject had an erection during the night, then the perforations between
the stamps would be separated. Otherwise, without an erection, the stamps would
be intact as placed the night before. This was a somewhat crude inexpensive
test, and therefore better evidence of an erection was needed.
The method of testing erectile ability during REM sleep, was
to place mercury strain gauges at the base of the penis, and also just under
the glans of the penis. When the penis became erect and engorged with blood,
the strain gauges would be stretched, and send a signal to the polysomnograph. The
beginning of the erection as the gauges enlarged was known as T–up. Maximal
enlargement was known as T–Max, and this was followed by T–down. [T=tumescence] This tracing
on the polysomnograph would then be correlated with REM sleep.
Usually during the second REM period, the technologist would
hurriedly go into the patient’s room with a Polaroid camera and a buckling
device. The patient would be uncovered, a picture would be taken of the
erection, and the buckling device would be pressed against the tip of the penis
to determine how many grams of pressure would be needed for the penis to
buckle. This procedure could be embarrassing for both the patient and the
technologist, especially if she were female.
We once had a female tech who said, “I’m not going to touch
any of those penises.” She devised a method of getting the strain gauges on the
penis, without having to touch the patient. Going to the local adult bookstore,
she purchased a dildo, which was molded from the penis of a well-known porn
star.
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