We measured the content of the two principal neurotransmitters of the autonomic nervous system from the erectile tissue of four men with normal erection and 38 men impotent as a result of injury or disease. In the former the norepinephrine content was 812 +/- 82.6 (SE) pg per mg of wet weight; In the latter, statistically significant reductions of norepinephrine were found with the greatest decrease occurring with insulin-dependent diabetes mellitus. Neither choline acetyltransferase activity nor morphologic alterations of the nerve fibers of erectile tissue were observed in either group. Our findings suggest that the sympathetic nervous system is an integral component of human erection and that a functional alteration of the corporal nerve fibers occurs with several diseases associated with impotence.

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