Nocturnal penile tumescence test, revaluation of its utility after 1587 exams recorded from 1986 to 2024.

Introduction: The Authors report their 38-year experience with the use of nocturnal penile tumescence (NPT) testing.

Methods: Among over 46,000 patients evaluated for andrological issues since 1980, the NPT test was selectively proposed in cases of suspected psychogenic erectile dysfunction, as part of a standardized diagnostic workup, which included medical history, physical and genital examination, blood tests, and hormonal evaluation. The test aimed to assess nocturnal erectile function and support differential diagnosis.

Results: From June 20, 1986, to December 31, 2024, a total of 1,587 NPT recordings were performed in patients aged 16 to 90 years. Among these, 992 tests were conducted over three nights, 486 over two nights, and 109 for a single night. The majority of tests were completed without major issues and provided interpretable data. Overall, the test was well tolerated, with good patient compliance and minimal technical difficulties. In many cases, the recordings allowed useful diagnostic insights into the nature of erectile dysfunction. In nearly all cases, patients exhibited varying degrees of anxiety concerning their ED, often interpreted as a consequence rather than the cause of an underlying organic condition.

Conclusions: After nearly four decades of clinical use, NPT testing has proven to be a reliable and informative component of the diagnostic approach to erectile dysfunction. Its ability to offer objective data in a home setting, with minimal discomfort and high patient compliance, makes it a useful adjunct in distinguishing psychogenic from etiologies.