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Tests such as the bulbocavernosus reflex test are used to determine if there is sufficient nerve sensation in the penis. During the late 16th and 17th centuries in France, male impotence was considered a crime, as well as legal grounds for a divorce. A physician measures the latency between squeeze and contraction by observing the anal sphincter or by feeling it with a gloved finger inserted past the anus. The man's comfort level is also frequently a factor, especially in maintaining an erection. This type of device is sometimes referred to as penis pump and may be used just prior to sexual intercourse. Modern drug therapy for ED made a significant advance in 1983, when British physiologist Giles Brindley dropped his trousers and demonstrated to a shocked Urodynamics Society audience his papaverine-induced erection.[30] The drug Brindley injected into his penis was a non-specific vasodilator, an alpha-blocking agent, and the mechanism of action was clearly corporal smooth muscle relaxation. Several types of FDA approved vacuum therapy devices are available with a doctor's prescription. There are two forms of impotence: primary and secondary. A significant proportion of men who have no sexual dysfunction nonetheless do not have regular nocturnal erections. If the stamp is no longer in place by morning, it means that a nocturnal erection occurred. During the late 16th and 17th centuries in France, male impotence was considered a crime, as well as legal grounds for a divorce. Impotence, or erectile dysfunction, was once regarded as a man's worst nightmare. Boredom, marital problems or negative feelings toward your partner may contribute to an impotence problem. It's important to realize that impotence may be a symptom of a more serious health problem, so if you're impotent, seek professional medical help immediately. One of the most underestimated causes of impotence is cigarette smoking — as if you need yet another reason to quit. More drastically, inflatable or rigid penile implants may be fitted surgically. In both conditions, an intact neural system is required for a successful and complete erection. Penile erection is managed by two mechanisms: the reflex erection, which is achieved by directly touching the penile shaft, and the psychogenic erection, which is achieved by erotic or emotional stimuli.

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