Salinas Casado Jesús, Vírseda Chamorro Miguel, Saenz de Tejada Iñigo, Allona Almagro Antonio, Ramírez Fernández Juan Carlos, Litton Muñoz Miguel
Hospital Ruber Internacional, Madrid, España.
Arch Esp Urol. 2003 Jan-Feb;56(1):61-8.
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).
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).
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.
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.
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。
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。
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。
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。