Bird S J, Hanno P M
Department of Neurology, University of Pennsylvania Medical Center, Philadelphia 19104, USA.
J Neurol Sci. 1998 Jan 21;154(1):8-13. doi: 10.1016/s0022-510x(97)00169-x.
The electrophysiologic evaluation of patients with erectile dysfunction presents an important diagnostic challenge. The bulbocavernosus reflex (BCR) latency has been commonly used to evaluate these disorders. However, it is a measure of somatic penile innervation, whereas erection is primarily dependent on autonomic function. We evaluated 195 men with erectile dysfunction over a 3 year period. Each had electrophysiologic studies, nerve conduction studies and a BCR. BCR studies were abnormal in only 7%, of which most had diabetes or pelvic trauma. The BCR was the sole electrophysiologic abnormality in only 2%. Autonomic testing (AT) was additionally performed in 19 diabetic and 23 non-diabetic patients. This included sympathetic skin responses and measurement of the Valsalva ratio and heart rate variability with 6/min breathing. In the diabetic group, AT was positive in 63%, and most often was the sole abnormality. The bulbocavernosus reflex is relatively insensitive in the diagnosis of erectile dysfunction. Brief autonomic testing may provide valuable additional data, particularly in diabetics.
勃起功能障碍患者的电生理评估是一项重要的诊断挑战。球海绵体反射（BCR）潜伏期一直常用于评估这些疾病。然而，它是对躯体性阴茎神经支配的一种测量，而勃起主要依赖于自主神经功能。我们在3年期间对195名勃起功能障碍男性进行了评估。每个人都进行了电生理研究、神经传导研究和BCR检查。BCR检查仅7%异常，其中大多数患有糖尿病或盆腔创伤。BCR是唯一电生理异常的情况仅占2%。另外对19名糖尿病患者和23名非糖尿病患者进行了自主神经测试（AT）。这包括交感神经皮肤反应以及通过每分钟6次呼吸测量瓦尔萨尔瓦比率和心率变异性。在糖尿病组中，AT阳性率为63%，且大多是唯一的异常情况。球海绵体反射在勃起功能障碍的诊断中相对不敏感。简短的自主神经测试可能会提供有价值的额外数据，尤其是在糖尿病患者中。
