Soler J M, Previnaire J G, Amarenco G
Centre Bouffard Vercelli, 66290 Cerbere, France.
2Spinal Unit, Centre Calve, Fondation Hopale, 62600 Berck-sur-Mer, France.
Spinal Cord Ser Cases. 2017 Dec 13;3:17097. doi: 10.1038/s41394-017-0024-9. eCollection 2017.
Prospective clinical series.
The dartos reflex (DR) produces unilateral elevation of the testis with vermicular contraction of the scrotal skin and penile retraction. It is a somato-autonomic reflex that depends on the T11-L2 sympathetic segment. Its presence was analysed in men with various levels and severities of spinal cord injury (SCI).
France.
Male patients with SCI undergoing urodynamic or sexual assessment were included. DR of the scrotum and penis were systematically assessed in addition to the usual neurological examination that included assessment of the autonomic system, cremaster, and sacral reflexes. The DR was evoked by applying a small ice pack on the scrotum, separately to each side.
Forty-six patients were assessed. DRs were always present when the T11-L2 segment was intact above the lesion (low paraplegia below L2) or below the lesion in an upper motor neuron (UMN) syndrome (spastic paraplegia above T10). They were more pronounced in the case of UMN syndrome. In the case of lower motor neuron (LMN) syndrome that included the T11-L2 segment, DRs disappeared in all but one patient. Patients with a LMN lesion were more prone to retrograde or absent ejaculation, loss of psychogenic erection, and open bladder neck.
The DR is a valuable test for the assessment of the integrity and excitability of the T11-L2 spinal segment. It is easy to perform and is predictive of some aspects of sexual and bladder neck function in men. DR should be considered as an addition to the autonomic standards.
前瞻性临床系列研究。
肉膜反射（DR）可使睾丸单侧抬高，伴有阴囊皮肤蠕动性收缩和阴茎回缩。它是一种躯体自主反射，依赖于胸11至腰2交感神经节段。对不同程度和严重程度脊髓损伤（SCI）的男性患者进行了该反射的分析。
法国。
纳入接受尿动力学或性功能评估的SCI男性患者。除了包括自主神经系统、提睾肌和骶反射评估在内的常规神经学检查外，还系统评估了阴囊和阴茎的DR。通过在阴囊两侧分别放置一个小冰袋来诱发DR。
共评估了46例患者。当胸11至腰2节段在损伤平面上方完整（腰2以下低位截瘫）或在上运动神经元（UMN）综合征（胸10以上痉挛性截瘫）的损伤平面下方时，DR总是存在。在UMN综合征的情况下，DR更为明显。在包括胸11至腰2节段的下运动神经元（LMN）综合征病例中，除1例患者外，其余患者的DR均消失。LMN损伤患者更容易出现逆行射精或无射精、精神性勃起丧失和膀胱颈开放。
DR是评估胸11至腰2脊髓节段完整性和兴奋性的一项有价值的检查。它操作简便，可预测男性性功能和膀胱颈功能的某些方面。DR应被视为自主神经评估标准的补充。
