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[海绵体肌电图在勃起功能障碍诊断中的应用新进展]

[New contributions of the usefulness of electromyography of cavernous bodies in the diagnosis of erectile dysfunction].

作者信息

Salinas Casado Jesús, Vírseda Chamorro Miguel, Saenz de Tejada Iñigo, Allona Almagro Antonio, Ramírez Fernández Juan Carlos, Litton Muñoz Miguel

机构信息

Hospital Ruber Internacional, Madrid, España.

出版信息

Arch Esp Urol. 2003 Jan-Feb;56(1):61-8.

Abstract

OBJECTIVES

To test the concordance between clinical and neurophysiologic data of the various types of erectile dysfunction, and to describe a diagnostic algorithm based on corpus cavernosum electromyography (cc-EMG).

METHODS

32 patients with a mean age of 50.6 years (typical deviation 13.2 years) referred with the diagnosis of erectile dysfunction underwent medical history, neuroandrologic physical exam, neurophysiologic studies (bulbocavernous muscle electromyography, S2-S4 latency period, threshold and latency of pudendal nerve somatosensory potentials, as well as genital sympathetic evoked potentials-SSR-), and corpus cavernosum electromyography(cc-EMG) both in basal conditions and after administration of 20 micrograms of E-1 prostaglandin (PGE-1).

RESULTS

1--A significative relationship was shown between clinical data of arterial or corpus cavernosum intrinsic origin erectile dysfunction and patients with vascular or structural lesion on cc-EMG data. 2--A significative relationship was shown between patients without previous pathologic history and patients with normal or anxiety cc-EMG. 3--No significative relationship was shown between patients with neurologic lesion and patients with autonomic lesion on cc-EMG. 4--No significative relationship was found between patients with peripheric neurologic lesion and patients with inferior autonomic lesion on cc-EMG. 5--A significative relationship was shown between patients with suprasacral neurologic lesion and patients with superior autonomical lesion on cc-EMG.

CONCLUSIONS

Isolated application of pudendal nerve neurophysiologic techniques for the diagnosis of erectile dysfunction is not enough. Autonomic innervation studies should be included, with a cc-EMG dichotomic qualitative interpretation.

摘要

目的

检测各类勃起功能障碍的临床数据与神经生理学数据之间的一致性,并描述一种基于海绵体肌电图(cc-EMG)的诊断算法。

方法

32例平均年龄50.6岁(标准差13.2岁)、诊断为勃起功能障碍的患者接受了病史采集、神经男科体格检查、神经生理学研究(球海绵体肌肌电图、S2-S4潜伏期、阴部神经体感诱发电位的阈值和潜伏期以及生殖交感神经诱发电位-SSR-),并在基础状态及给予20微克E-1前列腺素(PGE-1)后进行了海绵体肌电图(cc-EMG)检查。

结果

1-动脉性或海绵体原发性勃起功能障碍的临床数据与cc-EMG数据显示有血管或结构病变的患者之间存在显著关系。2-既往无病理病史的患者与cc-EMG正常或提示焦虑的患者之间存在显著关系。3-cc-EMG显示神经病变患者与自主神经病变患者之间无显著关系。4-cc-EMG显示周围神经病变患者与低位自主神经病变患者之间无显著关系。5-cc-EMG显示骶上神经病变患者与高位自主神经病变患者之间存在显著关系。

结论

单独应用阴部神经神经生理学技术诊断勃起功能障碍是不够的。应纳入自主神经支配研究,并对cc-EMG进行二分法定性解释。

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