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Impotence secondary to Disc Injury

I am a lawyer in NYC.  My client suffers from impotence secondary to disc injury.  I am looking for reference materials, textbooks, treatises, articles, etc., to educate myself on how the disc injury causes impotence.  I will have to cross examine a doctor who will testify that the the disc injury is not causing the ED.  Can you provide any assistance in locating materials to help me educate my self and prepare for trial.

Thank you

Cory Rosenbaum
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Here are some articles abstracts that you may want inquire about.  The following is taken from MedLine:

1) Urol Clin North Am. 2001 May;28(2):289-308.  
Neurologic erectile dysfunction.

Nehra A, Moreland RB.

Department of Urology, Mayo Medical School, and Mayo Clinic and Foundation, Rochester, Minnesota, USA. nehra.***@****

Neurologic erectile dysfunction presents a diagnostic and treatment challenge to the internist and urologist. Multiple chronic disease modalities and traumatic etiologies exist. Education regarding these conditions and a detailed and thorough history and office work-up are the best resources for the clinician. Treatment can follow the model of proceeding from the least to most invasive procedure (process of care), taking into account patient and partner satisfaction. Because the psychology of grief and loss may enter into treatment of some neurologic conditions (e.g., erectile dysfunction after radical retropubic prostatectomy, spinal cord injury, or chronic diseases), a whole-patient approach encompassing psychotherapy is warranted.

2) J Clin Laser Med Surg. 1999 Feb;17(1):25-7.  
Early relief of erectile dysfunction after laser decompression of herniated lumbar disc.

Choy DS.

Laser Spine Center, New York, New York, USA.

OBJECTIVE: The use of percutaneous laser disc decompression (PLDD) for the treatment of erectile dysfunction caused by herniated disc disease is described. SUMMARY BACKGROUND DATA: Disc herniation is often overlooked as a cause of erectile dysfunction, with few cases reported in the literature. METHODS: Two patients with erectile dysfunction were treated with PLDD as outpatients. RESULTS: In addition to the early return of erectile function in both cases, immediate pain relief was achieved in the second case. Follow-up visits confirmed continued normal sexual function and lack of pain. CONCLUSIONS: The literature now includes 23 cases well-documented cases of erectile dysfunction caused by spinal cord disc herniation. PLDD is a minimally invasive procedure that that can be used to treat herniation of intervertebral discs, which has been found to cause erectile dysfunction.

3) JAMA. 1971 Apr 19;216(3):520.  Related Articles, Links  
Impotence in the low-back syndrome.

Amelar RD, Dubin L.

4) Paraplegia. 1973 Nov;11(3):221-7.  Related Articles, Links  
About the neurological sequelae of herniated intravertebral disc.

Maury M, Francois N, Skoda A.

5) N Y State J Med. 1969 Sep 15;69(18):2465-70.  
Occult lumbar disk causing impotency.

Shafer N, Rosenblum J.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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