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the discrepancy between the amelioration in the perceived penile erectile function at IIEF-6 questionnaire and the lack of significant changes in the penile vascular function at dynamic PDU in patients with severe vasculogenic ED might be explained by a potential psychological benefit deriving from treatment, mainly represented by a significant improvement of the subjective perceived quality of penile erection, which was not reflected by an objective improvement of the severe underlying organic disease, a discrepancy occasionally reported in the clinical practice