Normal androgenic function has already been reported elsewhere as a fact in impotent diabetic males. Many of these patients show some type of visceral or peripheral diabetic neuropathy. Looking for a possible neurological origin for impotence in diabetic men, we have undertaken the present study, analyzing the autonomic nervous fibers of the corpora cavernosa of the penis by means of light microscopy.
In five autopsies of impotent diabetics, mean age 51, with an average duration of diabetes of 9.6 years, the following stainings were made: hematoxylin-eosin, P.A.S. and silver impregnations. Out of five cases, four showed morphological alterations of varying degrees (hyperargentophilia, beaded thickening, spindle shaped thickening, and argentophilic spherical swellings).
No correlations were found with diabetic microangiopathy. Only one of the diabetics did not show any lesion. The control group, five non-impotent, nondiabetic patients of similar age, did not show alterations at all.
This first study of the autonomic nervous system in the corpora cavernosa of impotent diabetics lends strong support to the idea that their sexual impotence is due to a neurological lesion of the nerve fibers that control erection.