Impotence Following Anesthesia for Elective Circumcision

SEXUAL impotence is a distressing problem in any age group. Acquired impotence occurs rarely after massive pelvic trauma but otherwise results from extirpative surgery for a malignant neoplasm. In the young, sexually active male, unexpected impotence is catastrophic. We recently observed two young men, both of whom were rendered impotent apparently by local anesthesia for elective circumcision.

Patients and Methods 

Case 1.—  In November 1976 a 24-year-old man was seen who had a loss of sexual potency since an elective circumcision performed 18 months previously. His erections were normal at the base and the glans but flaccid in the distal part of the shaft and of insufficient quality to allow penetration. There were no abnormalities disclosed by examination of the phallus. Photographs taken by the patient at the time of sexual excitement were consistent with his description. Findings of the remainder of the physical examination were normal. Corpus cavernography was