The discovery of erection during REM sleep has helped progress in the treatment of impotence. There are two main types of impotence. The first type arises for psychological reasons. It is well known that some men can have sex with their wives but are unable to with their mistresses, or vice versa. A variety of psychological reasons are involved, such as anxiety over the fear of being discovered and a sense of guilt, fear of catching venereal disease, etc. This psychological impotence is best treated by psychological means. The second type results from physical illness; after a bad accident or a major operation in the pelvic area, a man may not be able to have an erection at any time. A penis implant has now been developed that can help those who are impotent because of physical illness. To sort out who is eligible for this implant, the impotent candidate has to spend a few nights in the sleep laboratory.
With the impotent candidate in the sleep laboratory, a gadget can be placed around the penis to record any erection occurring during REM sleep. This recording is called nocturnal penile tumescence or NPT, and a positive reading is a reliable indicator of psychological causes of impotence. In Melbourne, at the Cabrini Hospital, two strain gauges are placed around the penis and recordings are made on a scroll of graph paper running throughout the night Patients who have positive NPT readings are having erections and are suffering from psychological impotence. Sometimes they can be woken up during an episode of REM sleep while they are having a dream erection. The mere demonstration of their ability to have an erection can give them tremendous confidence, and their condition can sometimes be cured spontaneously as they now know that they are in fact potent.
Before the discovery of dream erections and the ability to measure NPT, most experts believed that 90 per cent of impotence resulted from psychological causes, and most impotent patients were sent to see the psychiatrist. However, since the discovery of dream erections, there has been a complete change of attitude. The experts now believe that only about 50 per cent of cases of impotence arise from psychological causes, with the other 50 per cent being the result of physical illness.
Patients who are impotent because of physical illness do not have positive NPT readings, and an implant may be able to reverse their status. There are now a variety of implants that can be surgically placed in the flaccid penis. One ingenious technique from the USA is to implant a long inflatable double sausage made of polyurethane into the penis. This is connected by thin tubes to a small bag acting as a reservoir of fluid and situated in the abdominal muscles. It is also connected by similar tubes to a small pump, rather like a third testicle, in the scrotum. When the patient wants to have sex, he can give his third testicle a squeeze, and the fluid is transferred from the reservoir to the inflatable implant in the penis to achieve
a good erection. He can maintain this erection as long as his partner desires. When they have finished, all he has to do is give the third testicle another squeeze and a special valve allows the fluid to be transferred out of the penis. Nowadays these operations are performed all over the world.
What about women? The clitoris, the most sensitive part of the female genitalia, is the equivalent of the male penis. Developmentally, parts of the body undergo involution if they serve no purpose. An example is breasts in men, as they are not required to feed babies. During REM sleep, the clitoris goes into engorgement and hardening, similar to the penis in men. So for the lady reader, do not think that dream erections refer only to men. Next time you wake up from a dream, feel your clitoris.