Stief C G, Sauerwein D, Thon W F, Allhoff E P, Jonas U
Department of Urology, Medizinische Hochschule Hannover, Germany.
J Urol. 1992 Jul;148(1):107-10. doi: 10.1016/s0022-5347(17)36526-6.
Registration of cavernous electrical activity (single potential analysis of cavernous electrical activity) was recently suggested for the diagnosis of autonomic cavernous dysfunction. For validation of this method the effect of sacral neurostimulation on cavernous electrical activity was examined. In 3 male patients with a complete spinal cord lesion (T3, T4 and T12, respectively), deafferentation was done at the S2 to S5 levels. Around the anterior roots of S2 to S5 electrodes for neurostimulation were placed. Cavernous electrical activity was recorded with an intracavernous needle electrode and with surface electrodes in the flaccid as well as in the erect states induced by neurostimulation (at 7, 8, 12, 18, 20, 30 and 45 Hz., 30 v. and 0.4 msec). In all patients similar potentials compared to the normal values, as well as additional pathological potentials were recorded during flaccidity. During neurostimulation all patients achieved full erection with no or markedly decreased cavernous electrical activity to frequencies of 12, 18, 20 and 30 Hz., while to 7, 8 and, more pronounced, 45 Hz. only partial erection with ongoing cavernous electrical activity was found. Our study strongly suggests that cavernous electrical activity and, subsequently, the cavernous smooth muscle tone are dependent on autonomic input. This finding supports the hypothesis that single potential analysis of cavernous electrical activity may be valid in the diagnosis of cavernous autonomic dysfunction. Furthermore, our results suggest a possible role for single potential analysis of cavernous electrical activity in the fine tuning of erection inducing neurostimulators.
最近有人提出记录海绵体电活动（海绵体电活动的单电位分析）用于诊断自主神经性海绵体功能障碍。为验证该方法，研究了骶神经刺激对海绵体电活动的影响。在3例分别为T3、T4和T12完全性脊髓损伤的男性患者中，在S2至S5水平进行去传入神经手术。在S2至S5前根周围放置用于神经刺激的电极。通过海绵体内针电极以及在神经刺激诱导的松弛和勃起状态下用表面电极记录海绵体电活动（频率为7、8、12、18、20、30和45Hz，电压30V，脉宽0.4ms）。在所有患者中，松弛状态下记录到与正常值相似的电位以及额外的病理电位。在神经刺激期间，所有患者均实现完全勃起，频率为12、18、20和30Hz时海绵体电活动无或明显降低，而频率为7、8以及更明显的45Hz时，仅发现伴有持续海绵体电活动的部分勃起。我们的研究强烈表明，海绵体电活动以及随后的海绵体平滑肌张力依赖于自主神经输入。这一发现支持了海绵体电活动单电位分析在诊断海绵体自主神经功能障碍中可能有效的假说。此外，我们的结果提示海绵体电活动单电位分析在勃起诱导神经刺激器的微调中可能发挥作用。
