Clinical value of combined electrophysiological and urodynamic recordings to assess sexual disorders in spinal cord injured men.
Details
Serval ID
serval:BIB_FC633C76BD50
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Clinical value of combined electrophysiological and urodynamic recordings to assess sexual disorders in spinal cord injured men.
Journal
Neurourology and Urodynamics
ISSN
0733-2467 (Print)
ISSN-L
0733-2467
Publication state
Published
Issued date
2003
Volume
22
Number
4
Pages
314-321
Language
english
Notes
Publication types: Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Abstract
AIMS: To assess the significance of combined neurophysiological and neurourological examinations for diagnosis of neurogenic male sexual dysfunction.
METHODS: This is a prospective study of 32 spinal cord injured men. Each underwent clinical and neurophysiological examinations (sympathetic skin responses (SSR), pudendal somato-sensory evoked potentials (P-SSEP), bulbocavernosus reflex (BCR)) and neuro-urological measurements (urodynamic examination (UE), reflex erections (RE), psychogenic erections (PE) and nocturnal penile tumescence recordings (NPTR)).
RESULTS: Erectile dysfunction due to impairment of RE was associated with loss of BCR and detrusor areflexia (P > 0.001), whereas that due to impairment of PE was associated with loss of perineal SSR (P < 0.001). P-SSEP corresponded in 94% with impairment of penile sensibility and duration of erections in NPTR. The NPTRs were less related to functional sexual impairment. NPTRs in complete and incomplete suprasacral (level > T10) spinal lesion showed sufficient erections despite strongly disturbed PE. NPTRs in lumbosacral lesion revealed significant reduction in or absent erections and underestimated the presence of well excitable PE.
CONCLUSIONS: Combined neurophysiologic and neurourologic testing provides highly relevant diagnostic informations about sexual dysfunction in men with spinal cord injury. Loss of the BCR and detrusor areflexia imply loss of somatic and parasympathetic reflex activity and correlate with loss of RE. Loss of PE correlates with loss of perineal SSR (sympathetic denervation).
METHODS: This is a prospective study of 32 spinal cord injured men. Each underwent clinical and neurophysiological examinations (sympathetic skin responses (SSR), pudendal somato-sensory evoked potentials (P-SSEP), bulbocavernosus reflex (BCR)) and neuro-urological measurements (urodynamic examination (UE), reflex erections (RE), psychogenic erections (PE) and nocturnal penile tumescence recordings (NPTR)).
RESULTS: Erectile dysfunction due to impairment of RE was associated with loss of BCR and detrusor areflexia (P > 0.001), whereas that due to impairment of PE was associated with loss of perineal SSR (P < 0.001). P-SSEP corresponded in 94% with impairment of penile sensibility and duration of erections in NPTR. The NPTRs were less related to functional sexual impairment. NPTRs in complete and incomplete suprasacral (level > T10) spinal lesion showed sufficient erections despite strongly disturbed PE. NPTRs in lumbosacral lesion revealed significant reduction in or absent erections and underestimated the presence of well excitable PE.
CONCLUSIONS: Combined neurophysiologic and neurourologic testing provides highly relevant diagnostic informations about sexual dysfunction in men with spinal cord injury. Loss of the BCR and detrusor areflexia imply loss of somatic and parasympathetic reflex activity and correlate with loss of RE. Loss of PE correlates with loss of perineal SSR (sympathetic denervation).
Keywords
Adolescent, Adult, Erectile Dysfunction/diagnosis, Erectile Dysfunction/etiology, Evoked Potentials, Somatosensory, Humans, Male, Middle Aged, Muscle Hypertonia/diagnosis, Muscle Hypertonia/etiology, Parasympathetic Nervous System/physiopathology, Reflex, Severity of Illness Index, Spinal Cord Injuries/complications, Spinal Cord Injuries/physiopathology, Sympathetic Nervous System/physiopathology, Urodynamics
Pubmed
Web of science
Create date
05/11/2014 13:13
Last modification date
20/08/2019 17:27