Stief C G, Höppner C, Sauerwein D, Jonas U
Department of Urology, Medizinische Hochschule Hannover, Germany.
J Urol. 1994 Feb;151(2):367-72. doi: 10.1016/s0022-5347(17)34951-0.
Introduced in 1988, cavernous electromyography and its evolution, single potential analysis of cavernous electrical activity (SPACE), seem to be promising diagnostic methods in the evaluation of erectile dysfunction. The aim of our study was to determine the influence of a centrally disturbed autonomic supply on SPACE recordings. SPACE was performed in 35 male patients with complete and 2 with incomplete spinal cord lesions at a cervical or thoracic level. Simultaneous recording was done with concentric needle electrodes in both cavernous bodies with a frequency range of 0.5 to 100 Hz. All patients underwent a full neurological and urological evaluation, including cystometry. The lesion was cervical in 12 patients and thoracic in 22. Three patients underwent sacral deafferentation and bladder pacemaker implantation. One of 12 patients with cervical and 10 of 22 with thoracic lesions reported full rigid reflexogenic erections, while 3 of 12 patients with cervical lesions were not evaluable due to grounding failure. Of these patients 31 were eligible for our study. No patient had an entirely normal SPACE. Four of 9 patients with cervical and 19 of 22 with thoracic lesions had a normal, silent basic electric (less than 5 mu v.) oscillation, while the remainder had a baseline oscillation of up to 100 mu v. Normal potentials were found in 2 of 9 and 10 of 22 patients, respectively. Low frequency, high amplitude potentials were found in 6 of 9 and 21 of 22 patients, respectively, while low frequency, low amplitude potentials occurred in 8 and 8, respectively, and high frequency potentials occurred in 5 and 1, respectively. Our results show that abnormal autonomic input induces abnormal SPACE findings in patients with (presumably) normal cavernous tissue.
海绵体肌电图于1988年被引入，其发展形式——海绵体电活动单电位分析（SPACE），在勃起功能障碍评估中似乎是很有前景的诊断方法。我们研究的目的是确定中枢性自主神经供应紊乱对SPACE记录的影响。对35例颈段或胸段脊髓完全损伤的男性患者和2例不完全损伤的男性患者进行了SPACE检查。使用同心针电极在两个海绵体内同时记录，频率范围为0.5至100赫兹。所有患者均接受了全面的神经学和泌尿学评估，包括膀胱测压。12例患者损伤部位在颈部，22例在胸部。3例患者接受了骶神经去传入术和膀胱起搏器植入术。12例颈部损伤患者中有1例、22例胸部损伤患者中有10例报告有完全的反射性勃起，12例颈部损伤患者中有3例因接地故障无法评估。这些患者中有31例符合我们的研究条件。没有患者的SPACE完全正常。9例颈部损伤患者中有4例、22例胸部损伤患者中有19例有正常的、安静的基础电活动（小于5微伏）振荡，其余患者的基线振荡高达100微伏。9例患者中有2例、22例患者中有10例分别发现正常电位。9例患者中有6例、22例患者中有21例分别发现低频、高振幅电位，低频、低振幅电位分别出现在8例和8例患者中，高频电位分别出现在5例和1例患者中。我们的结果表明，异常的自主神经输入会在（推测）海绵体组织正常的患者中诱导出异常的SPACE结果。
