Bulbocavernosus reflex latencies and somatosensory evoked potentials after pudendal nerve stimulation in the diagnosis of impotence

Tackmann, W.; Porst, Hartmut; Ahlen, H. van

doi:10.1007/bf00314350

Cited by 46 publications

(22 citation statements)

References 29 publications

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“…With respect to Tackmann et al, 7,8 who reported mean-latencies of 41.7 with a s.d. of 2.8 ms within 30 healthy controls, P1-latency was considered to be normal up to 48.7 ms (mean 2.5 s.d.).…”

Section: Pudendal Nerve Ssepmentioning

confidence: 91%

“…BCR-latency-measurement was performed according to Tackmann et al 7 with the subject in a supine position. Dorsal penile nerve (DPN) was stimulated electrically by means of ring electrodes applied around the penile shaft, the cathode in the corona glandis and the anode more proximally with a 2±3 cm distance.…”

Section: Bcr-latency-measurementmentioning

confidence: 99%

“…Normal values were adapted from Tackmann et al 7 In order to achieve reasonable standards of comparison with other authors' work, results were considered pathological if mean BCR-L was higher than 2.5 times s.d. on one or both sides.…”

Section: Bcr-latency-measurementmentioning

confidence: 99%

“…1±3 With regard to vascular disorders, in 27% of males affected with erectile dysfunction was reported arterial and in 29% cavernous impairment. 4 The ratio of pathological ®ndings in neurophysiological examinations ranges from 15% for BCR-L measurement vs 13% for pudendal SSEP recordings 3 and 16% pathological BCR-L vs 2% pathological pudendal SSEP, 5 respectively, up to 50% pathological BCR-L vs 26% pathological pudendal SSEP 6,7 in de®ned groups of impotent patients with various diagnoses.…”

Section: Introductionmentioning

confidence: 99%

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Bulbocavernosus-reflex latencies and pudendal nerve SSEP compared to penile vascular testing in 669 patients with erectile failure and other sexual dysfunction

Fabra¹,

Porst²

1999

Int J Impot Res

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The purpose of this current study was to ®nd out the coincidence of pathological penile vascular supply with pathological data in Bulbocavernosusre¯ex latency (BCR-L) measurements and Pudendal Nerve SSEP (PudSSEP) recordings. Six hundred and sixty-nine males (642 with erectile dysfunction, 27 with different sexual disturbances) (mean age 49.3 y, range 17±76 y) underwent consecutively a battery of neurophysiological investigations together with pharmacotesting of cavernous bodies combined with duplex sonography of penile arteries. Pathological vascular ®ndings were indicated in 286 men (43%), pathological neurophysiological ®ndings in 264 men (39%). Normal ®ndings in both investigations (vascular and neurophysiological) were encountered in 252 men (38%); 131 men (19%) revealed pathological data exclusively in the neurophysiological parameters, 153 (23%) exclusively in the vascular parameters and 133 (20%) in both.The highest percentages of pathological ®ndings were observed in patients with diabetes mellitus (110 out of 131, 88%) and patients who had sustained pelvic trauma or surgery (36 out of 44, 82%), in contrast to the lowest percentage in patients with a proven psychogenic etiology (10 out of 38, 26%). Somewhat surprising was the rather high proportion of vascular impairment in patients with de®ned neurological diseases such as alcohol abuse (20 out of 51, 43%), polyneuropathy (PNP) of various etiology (9 out of 19, 47%), lumbosacral radiculopathies (26 out of 65, 40%), and CNS diseases (24 out of 52, 46%), about half of them coinciding with pathological neurophysiological ®ndings. Even if the validity of BCR-L measurement and PudSSEP recordings in the assessment of neurogenic impotence was controversely discussed, we conclude that in a large number of impotent males both neurogenic and vascular factors are responsible for the onset of erectile dysfunction.

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Section: Pudendal Nerve Ssepmentioning

confidence: 91%

Section: Bcr-latency-measurementmentioning

confidence: 99%

Section: Bcr-latency-measurementmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Bulbocavernosus-reflex latencies and pudendal nerve SSEP compared to penile vascular testing in 669 patients with erectile failure and other sexual dysfunction

Fabra¹,

Porst²

1999

Int J Impot Res

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show abstract

“…Especially with regards to topographic relations of presumed sites of neurogenic lesions, the possibility to examine selectively the different branches of the pudendal nerve becomes more and more interesting. 9 This will also facilitate a differentiation between central and peripheral lesions. Our interest therefore was focused on evaluation of the diagnostic relevance of penile and perianal pudendal SSEP by direct comparison of the methods.…”

Section: Introductionmentioning

confidence: 99%

Penile and perianal pudendal nerve somatosensory evoked potentials in the diagnosis of erectile dysfunction

et al. 2001

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Neurophysiologic examinations in differential diagnosis of erectile dysfunction comprise electromyogramme of the pelvic¯oor, pudendal nerve terminal motor latency (PNTML) and evaluation of pudendal somatosensory evoked potentials (SSEP). We focused our interest on comparing diagnostic importance of penile and perianal pudendal nerve SSEP.We examined 20 patients suffering from erectile dysfunction and 20 patients without any manifestation of impotence. The stimulus was administered using penile ring electrodes at the base of the penis (cathode) and distally on the penis shaft (anode), as well as a perianal surface electrode applied at 3 o'clock in lithotomy position and 5 cm laterally on the gluteal skin. The potentials were recorded with intradermal needle electrodes at C z ±2 cm (different) and F z (indifferent). 500 stimuli were averaged for a single tracing. The stimulus strength was set at an average of 3±4 times the stimulus threshold.Cortical latency of P 40 ranged from 39.0 to 45.6 ms (penile) and from 33.6 to 43.2 ms (perianal) in the control group, in the patient group latencies ranged from 38.8 to 51.6 (penile) and 34.0 to 44.8 ms (perianal). In two patients no potential was recordable after perianal stimulation, one patient showed a marked prolongation of the penile response with a normal perianal latency. Penile and perianal latencies of P 40 were signi®cantly prolongued in the patient group compared to the control group (P`0.05).The combination of penile and perianal pudendal SSEP may provide valuable additional information in differential diagnosis of erectile dysfunction, especially allowing to identify different sites of neurogenic lesions. In contrast to perianal pudendal SSEP, penile stimulation may help to discover pathologic changes in the distal course of the pudendal nerve, especially the dorsal nerve of the penis.

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Aaem minimonograph #48: Autonomic nervous system testing

1997

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Bulbocavernosus reflex latencies and somatosensory evoked potentials after pudendal nerve stimulation in the diagnosis of impotence

Cited by 46 publications

References 29 publications

Bulbocavernosus-reflex latencies and pudendal nerve SSEP compared to penile vascular testing in 669 patients with erectile failure and other sexual dysfunction

Bulbocavernosus-reflex latencies and pudendal nerve SSEP compared to penile vascular testing in 669 patients with erectile failure and other sexual dysfunction

Penile and perianal pudendal nerve somatosensory evoked potentials in the diagnosis of erectile dysfunction

Aaem minimonograph #48: Autonomic nervous system testing

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