The diagnosis and treatment of male impotence have been radically modified by the introduction of intracavernous injections of papaverine. Papaverine treatment can solve more than 70% of male impotence cases, so that the real clue to the diagnosis of impotence is to discriminate between patients who can be treated by papaverine alone and patients deserving thorough investigation. The association of papaverine injection plus video sexual stimulation for this purpose was adopted in our last 250 unselected patients and represents a valuable tool. 115 of 250 achieved successful treatment for their impotence according the following percentages: intracavernous papaverine injections at the practice or at home 75.8%; prosthesis, 19.1%; venous surgery, 3.4%, and arterial surgery, 1.7%.