Salinas Casado J, Vírseda Chamorro M, Samblás García R, Esteban Fuertes M, Aristizábal Agudelo J M, Delgado Martín J A, Blázquez Izquierdo J, Resel Estévez L
Servicio de Urología, Hospital Universitario San Carlos, Universidad Complutense, Madrid, España.
Arch Esp Urol. 1998 Apr;51(3):265-8.
To determine the neurologic alterations of patients with ejaculatory and orgasmic disorders.
A study of the neuroandrologic profile was performed in eight patients; 6 presented an ejaculation, one premature ejaculation and one presented an orgasm. The neuroandrologic profile consisted in performing selective electromyography of the bulbocavernosus muscle, recording of the S2-S4 evoked potentials, evoked somatosensory potentials of the pudendal nerve, electromyography of the smooth cavernous muscle (SPACE), sympathetic skin response and cystometry.
The sympathetic lesion was more frequent in the cases with an ejaculation (four cases; 66%); a pudendal efferent lesion was demonstrated in one case (17%) and a suprasacral lesion in one case (16%). A pudendal afferent lesion was observed in the two cases with premature ejaculation (100%). Both cases with an orgasm had a pudendal afferent lesion (100%) and one of them also presented a sympathetic lesion (50%).
An ejaculation appears to be caused by sympathetic, motor pudendal or suprasacral lesion. An altered perception of genital sensations due to lesion of the afferent pudendal pathway appears to be present in premature ejaculation. An orgasm could be ascribed to an alteration of the pudendal sensibility or to the absence of ejaculation.
确定射精和性高潮障碍患者的神经学改变。
对8例患者进行了神经男科检查；6例存在射精问题，其中1例为早泄，1例存在性高潮问题。神经男科检查包括球海绵体肌选择性肌电图检查、S2-S4诱发电位记录、阴部神经体感诱发电位、海绵体平滑肌肌电图（SPACE）、交感皮肤反应和膀胱测压。
射精患者中交感神经损伤更为常见（4例；66%）；1例（17%）显示阴部传出神经损伤，1例（16%）显示骶上神经损伤。2例早泄患者均观察到阴部传入神经损伤（100%）。2例性高潮患者均存在阴部传入神经损伤（100%），其中1例还存在交感神经损伤（50%）。
射精似乎由交感神经、阴部运动神经或骶上神经损伤引起。早泄患者因阴部传入神经通路损伤而出现生殖器感觉改变。性高潮可能归因于阴部感觉改变或无射精。
