Clinical Autonomic Neurophysiology and the Male Sexual Response: An Overview

Yang, Claire C.; Jiang, Xinghua

doi:10.1111/j.1743-6109.2008.01180.x

Cited by 34 publications

(17 citation statements)

References 26 publications

(26 reference statements)

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“…First, the autonomic nervous system plays the key role in providing the necessary signals for increased blood flow to the genitalia for both men (erection) and women (genital engorgement) as well as providing signals for the production of secretive fluids used for lubrication and seminal transfer (ejaculation: emission phase; McKenna, 2002; Temel et al, 2005; Yang and Jiang, 2009). Second, and the focus of this review, the somatic nervous system provides the signals for rhythmic contractions of the genital musculature in both men (ejaculation: expulsion phase) and women (vaginocervical contractions; Giuliano and Clement, 2005; Levin, 1998; Yang and Jiang, 2009). There is a surprisingly complex integration of ascending sensory information from the genitalia with both descending excitatory and inhibitory inputs to the spinal motor neurons.…”

Section: Introductionmentioning

confidence: 99%

Somatic genital reflexes in rats with a nod to humans: Anatomy, physiology, and the role of the social neuropeptides

Normandin

Murphy

2011

Hormones and Behavior

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Somatic genital reflexes such as ejaculation and vaginocervical contractions are produced through the striated muscles associated with the genitalia. The coordination of these reflexes is surprisingly complex and involves a number of lumbosacral spinal and supraspinal systems. The rat model has proved to be an excellent source of information regarding these mechanisms, and many parallels to research in humans can be drawn. An understanding of the spinal systems involving the lumbosacral spinal cord, both efferent and afferent, has been generated through decades of research. Spinal and supraspinal mechanisms of descending excitation, through a spinal ejaculation generator in the lumbar spinal cord and thalamus, and descending inhibition, through the ventrolateral medulla, have been identified and characterized both anatomically and physiologically. In addition, delineation of the neural circuits whereby ascending genitosensory information regarding the regulation of somatic genital reflexes is relayed supraspinally has also been the topic of recent investigation. Lastly, the importance of the “social neuropeptides” oxytocin and vasopressin in the regulation of somatic genital reflexes, and associated sociosexual behaviors, is emerging. This work not only has implications for understanding how nervous systems generate sexual behavior, but also provides treatment targets for sexual dysfunction in people.

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Section: Introductionmentioning

confidence: 99%

Somatic genital reflexes in rats with a nod to humans: Anatomy, physiology, and the role of the social neuropeptides

Normandin

Murphy

2011

Hormones and Behavior

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“…The second route continues through the paravertebral sympathetic chain, which connects via the pelvic splanchnic nerve to the pelvic plexus and then through the cavernous nerve to the penis. The last route also continues through the paravertebral sympathetic chain but leaves via the pudendal nerve to the penis (Giuliano and Rampin, ; Yang and Jiang, ; Everaert et al, ).…”

Section: Anatomy Of Orgasmmentioning

confidence: 99%

Anatomic variation and orgasm: Could variations in anatomy explain differences in orgasmic success?

2016

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Though the public consciousness is typically focused on factors such as psychology, penis size, and the presence of the "G-spot," there are other anatomical and neuro-anatomic differences that could play an equal, or more important, role in the frequency and intensity of orgasms. Discovering these variations could direct further medical or procedural management to improve sexual satisfaction. The aim of this study is to review the available literature of anatomical sexual variation and to explain why this variation may predispose some patients toward a particular sexual experience. In this review, we explored the available literature on sexual anatomy and neuro-anatomy. We used PubMed and OVID Medline for search terms, including orgasm, penile size variation, clitoral variation, Grafenberg spot, and benefits of orgasm. First we review the basic anatomy and innervation of the reproductive organs. Then we describe several anatomical variations that likely play a superior role to popular known variation (penis size, presence of g-spot, etc). For males, the delicate play between the parasympathetic and sympathetic nervous systems is vital to achieve orgasm. For females, the autonomic component is more complex. The clitoris is the primary anatomical feature for female orgasm, including its migration toward the anterior vaginal wall. In conclusions, orgasms are complex phenomena involving psychological, physiological, and anatomic variation. While these variations predispose people to certain sexual function, future research should explore how to surgically or medically alter these. Clin. Anat. 29:665-672, 2016. © 2016 Wiley Periodicals, Inc.

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“…However, brain stem, hypothalamic, and forebrain sites actuating genital engorgement, sexual positioning/posturing, copulatory activity, and ejaculation/orgasm (or its delay) seem more to participate in an evolving and inevitable cascade of events once higher centers have imagined, initiated, consented, and committed to the behavior (Fitzgerald and Mueller, 2004;Yang and Jiang, 2009;Yoshimura and Chancellor, 2003). Distinctive and opposed medial ("M") and lateral ("L") pontine reticular formation sites have been identified for bladder storage/continence and micturition, respectively.…”

Section: Anatomy and Physiology Of Sexual Functionmentioning

confidence: 99%

Pelvic Autonomic Neuromonitoring

Skinner¹

2014

Journal of Clinical Neurophysiology

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Currently, the means to assess the autonomic nervous system primarily depend on end organ functional measurement: intravesical pressure, skin resistance, and penile strain gauge tension, for example. None of these measures has been generally accepted in the operating room. Nevertheless, the segmental and peripheral pelvic autonomic nerve supply is placed at risk during both pelvic and lower spine surgery. In this difficult era of suboptimal post-prostatectomy outcomes, the urological literature does reveal the salutary development of safer dissection techniques about the peri-prostatic and cavernous plexus. Means of reliably specific nerve identification remain elusive. The need for actual nerve monitoring (not just identification) has only recently been proposed. Data from the animal lab reinforce an appreciation of the intimate and elegant interconnectedness of autonomic and somatic structures, particularly at the segmental level. Also, the biochemistry of erectile tissue engorgement (in both sexes) is very well understood (the electrophysiology increasingly so). Understanding these principles should permit parallel investigation and implementation of neurophysiological techniques which both identify and monitor pelvic autonomic function. The predicates for these proposed new approaches in the operating room are discussed in this review.

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Clinical Autonomic Neurophysiology and the Male Sexual Response: An Overview

Cited by 34 publications

References 26 publications

Somatic genital reflexes in rats with a nod to humans: Anatomy, physiology, and the role of the social neuropeptides

Somatic genital reflexes in rats with a nod to humans: Anatomy, physiology, and the role of the social neuropeptides

Anatomic variation and orgasm: Could variations in anatomy explain differences in orgasmic success?

Pelvic Autonomic Neuromonitoring

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