Jost W H, Derouet H, Osterhage J, Schimrigk K, Ziegler M
Fachbereich Neurologie, Deutsche Klinik für Diagnostik, Wiesbaden.
Urologe A. 1996 Mar;35(2):120-6.
So far, electrophysiological examinations have rarely been used in the diagnosis of erectile dysfunction (ED) mainly because the methods available only allow somatic neuron pathways to be examined whose relevance for the mainly autonomically controlled crection is evaluated differently. At present, impaired penile nerve supply as the possible cause of ED can only be evaluated through neurophysiological screening of the somatic and autonomic pathways of the pelvic floor, and not just by one simple method. Diagnosing ED should include testing of motoric efferences through electroneurography of the pudendal nerve and electromyography of the external anal sphincter and the urethral sphincter. Sensitive afference is tested with somatosensory evoked potentials of the pudendal nerve. New methods that are available for the examination of autonomic pathways are the penile sympathetic skin response and the EMG of the corpus cavernosum. Together with the other electrophysiological examinations, they allow neurogenic causes to be determined and differentiate not only between central and peripheric lesions, but also between acute and chronic changes. Prognosis can also be estimated. A crucial diagnostic deficit is the fact that it is still not possible to test the parasympathetic system directly.
到目前为止，电生理检查很少用于勃起功能障碍（ED）的诊断，主要是因为现有的方法仅能检测躯体神经元通路，而对于主要由自主神经控制的勃起，其相关性的评估存在差异。目前，作为ED可能原因的阴茎神经供应受损只能通过对盆底躯体和自主神经通路进行神经生理筛查来评估，而不能仅通过一种简单方法。诊断ED应包括通过阴部神经电神经图和肛门外括约肌及尿道括约肌肌电图来检测运动传出功能。通过阴部神经体感诱发电位检测感觉传入功能。可用于检查自主神经通路的新方法是阴茎交感皮肤反应和海绵体肌电图。与其他电生理检查一起，它们不仅可以确定神经源性病因，区分中枢性和周围性病变，还能区分急性和慢性变化，还可以估计预后。一个关键的诊断缺陷是，目前仍然无法直接检测副交感神经系统。
