Fabra M, Porst H
Institut for Medical Expert Assessment, Hamburg, Germany.
Int J Impot Res. 1999 Jun;11(3):167-75. doi: 10.1038/sj.ijir.3900404.
The purpose of this current study was to find out the coincidence of pathological penile vascular supply with pathological data in Bulbocavernosusreflex latency (BCR-L) measurements and Pudendal Nerve SSEP (PudSSEP) recordings. Six hundred and sixty-nine males (642 with erectile dysfunction, 27 with different sexual disturbances) (mean age 49.3 y, range 17-76 y) underwent consecutively a battery of neurophysiological investigations together with pharmacotesting of cavernous bodies combined with duplex sonography of penile arteries. Pathological vascular findings were indicated in 286 men (43%), pathological neurophysiological findings in 264 men (39%). Normal findings in both investigations (vascular and neurophysiological) were encountered in 252 men (38%); 131 men (19%) revealed pathological data exclusively in the neurophysiological parameters, 153 (23%) exclusively in the vascular parameters and 133 (20%) in both. The highest percentages of pathological findings were observed in patients with diabetes mellitus (110 out of 131, 88%) and patients who had sustained pelvic trauma or surgery (36 out of 44, 82%), in contrast to the lowest percentage in patients with a proven psychogenic etiology (10 out of 38, 26%). Somewhat surprising was the rather high proportion of vascular impairment in patients with defined neurological diseases such as alcohol abuse (20 out of 51, 43%), polyneuropathy (PNP) of various etiology (9 out of 19, 47%), lumbosacral radiculopathies (26 out of 65, 40%), and CNS diseases (24 out of 52, 46%), about half of them coinciding with pathological neurophysiological findings. Even if the validity of BCR-L measurement and PudSSEP recordings in the assessment of neurogenic impotence was controversely discussed, we conclude that in a large number of impotent males both neurogenic and vascular factors are responsible for the onset of erectile dysfunction.
本研究的目的是找出阴茎病理血管供应与球海绵体反射潜伏期（BCR-L）测量和阴部神经体感诱发电位（PudSSEP）记录中的病理数据之间的一致性。669名男性（642名勃起功能障碍患者，27名患有不同性障碍）（平均年龄49.3岁，范围17 - 76岁）连续接受了一系列神经生理学检查，同时对海绵体进行药物测试并结合阴茎动脉双功超声检查。286名男性（43%）有病理血管发现，264名男性（39%）有病理神经生理学发现。两项检查（血管和神经生理学）均正常的有252名男性（38%）；131名男性（19%）仅在神经生理学参数方面有病理数据，153名（23%）仅在血管参数方面有病理数据，133名（20%）在两者方面都有病理数据。在糖尿病患者（131名中的110名，88%）和遭受盆腔创伤或手术的患者（44名中的36名，82%）中观察到的病理发现百分比最高，相比之下，在已证实有心理病因的患者中百分比最低（38名中的10名，26%）。 somewhat令人惊讶的是，在患有明确神经疾病的患者中，如酒精滥用（51名中的20名，43%）、各种病因的多发性神经病（PNP）（19名中的9名，47%）、腰骶神经根病（65名中的26名，40%）和中枢神经系统疾病（52名中的24名，46%），血管损伤的比例相当高，其中约一半与病理神经生理学发现一致。即使BCR-L测量和PudSSEP记录在评估神经源性阳痿中的有效性存在争议，但我们得出结论，在大量阳痿男性中，神经源性和血管性因素均导致勃起功能障碍的发生。
