Definition of secondary impotence depends upon acceptance of the concept of primary impotence as expressed and discussed in primary impotence. Primary impotence arbitrarily has been defined as the inability to achieve and/or maintain an erection quality sufficient to accomplish coital connection.
If erection is established and then lost from real or imagined distractions related to the coital opportunity, the erection usually is dissipated without an accompanying ejaculatory response. If diagnosed as primarily impotent, a man not only evidences erective inadequacy during his initial coital encounter but the dysfunction also is present with every subsequent opportunity.
If a man is to be judged secondarily impotent, there must be the clinical landmark of at least one instance of successful intromission, either during the initial coital opportunity or in a later episode. The usual pattern of the secondarily impotent male is success with the initial coital opportunity and continued effective performance with the first fifty, hundred, or even thousand or more coital encounters.
Finally, an episode of failure at effective coital connection is recorded.
