Clinical value of combined electrophysiological and urodynamic recordings to assess sexual disorders in spinal cord injured men

Schmid, Daniel; Curt, Armin; Hauri, D.; Schurch, Brigitte

doi:10.1002/nau.10125

Cited by 35 publications

(34 citation statements)

References 41 publications

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“…The predominant mode to document the effects of SCI on sexual response in men has been through self-report. 1 Recent research, primarily in females, 2 but also in males with SCIs, 3,4 has used a laboratory-based approach to document the effects of level and degree of SCI on arousal. These studies have shown that the neurologic ability to achieve psychogenic arousal can be predicted in both females 2 and males 5 by the degree of preservation of the combined ability to perceive surface sensation to pinprick and light touch in the T11-L2 dermatomes.…”

Section: Introductionmentioning

confidence: 99%

Effects of level and degree of spinal cord injury on male orgasm

2006

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Design: Controlled, laboratory-based analysis. Objective: To determine the impact of spinal cord injuries (SCIs) on the ability to achieve male orgasm. Setting: US academic medical center. Methods: A laboratory-based analysis of the ability of 45 men with SCIs and 16 able-bodied control subjects to achieve orgasm coupled with a detailed neurologic examination, history and physical examination, and administration of the International Index of Erectile Function. Results: Men with SCIs were less likely than controls to achieve orgasm. Mean latency to orgasm, blood pressure and heart rates at orgasm were not significantly different between controls and SCI subjects. Men with incomplete SCIs were more likely to achieve orgasm than those with complete SCIs. A disconnect was noted between the presence of orgasm and the presence of ejaculation. Men with complete lower motor neuron dysfunction affecting their sacral segments were less likely to achieve orgasm than men with any other patterns of SCI. Conclusion: These results document the ability of men with complete SCIs to achieve orgasm. Characteristics of orgasm in men with SCIs as compared to able-bodied subjects are similar. Although orgasm and ejaculation are more likely to occur together, a number of men with SCIs achieve orgasm without ejaculation. Further research should explore the possibility of retraining ejaculatory and orgasmic responses in men with SCIs.

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Section: Introductionmentioning

confidence: 99%

Effects of level and degree of spinal cord injury on male orgasm

2006

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“…2,11 Despite Significant association between RE and BCR Table 4 The relationship of pSSR with psychogenic erection and psychogenic lubrication…”

Section: Discussionmentioning

confidence: 99%

“…1 Neurophysiological examinations which evaluate distinct divisions of the nervous system such as sympathetic, parasympathetic and somatic nerve fibres, are considered to be crucial especially if they also provide prognostic information. 2,3 Electromyographic examination (EMG) of the pelvic floor muscles is valuable in the assessment of the involvement of the lower sacral segments. Pudendal somatosensory evoked potentials (pSEP) evaluate the afferent pathways arising from genital organs to upper centres, 4 perineal sympathetic skin responses (pSSR) evaluate symphatetic fibres, 5,6 and bulbocavernosus reflex (BCR) recordings evaluate the integrity of sacral reflex arc.…”

Section: Introductionmentioning

confidence: 99%

Electrophysiological assessment of sexual dysfunction in spinal cord injured patients

Tas

Altay

et al. 2006

Spinal Cord

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Study design: Survey. Objectives: To determine associations between sexual dysfunctions and electrophysiological examinations of the genital system in spinal cord injured patients. Setting: Ege University Hospital, Izmir, Turkey. Methods: In total, 25 patients (17 men, eight women) who were out of the spinal shock period were examined. Neurological levels were determined according to the American Spinal Injury Association (ASIA) impairment scale. Data about erection, ejaculation and vaginal lubrication were obtained via inquiry forms. Bulbocavernosus reflex (BCR), pudendal somatosensorial evoked potentials (pSEP) and perineal sympathetic skin responses (pSSR) were recorded by an electromyographer unaware of the sexual state or neurological level of the patient. Results: BCRs could be obtained from all patients with lesion levels above the sacral centre. A significant association was found between reflex erection and BCR positivity, while psychogenic erection was shown to have a significant association with the preservation of pSSR in men. Despite the lack of statistical significance due to the small sample size of the women examined, a similar association with lubrication was observed. Ejaculation and orgasm were not shown to be significantly associated with any electrophysiological examination. However, ejaculation was preserved in all men with a lesion level below T12 and with positive pSSR. There was no significant relationship between pSEP and sexual functions. The relationship between the existence of sacral sensation and pSEP positivity was statistically significant. Conclusion: This study has proved that BCR and pSSR have an important role in the estimation of the remaining sexual function in spinal cord injured patients. Statement on ethics: We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research.

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“…Recently, the use of physiological studies to document the effects of SCI on male sexual response has increased. Based on this research, the potential for psychogenic erection is likely related to preservation of sympathetic function to the genitals [3][4]. Until this finding is further documented, psychogenic erection is recommended to be described as present, possible though partially impaired, or absent based on patient report or physiological data, whether available or not ( Table 1).…”

Section: Male Sexual Functionmentioning

confidence: 99%

“…Until this finding is further documented, psychogenic erection is recommended to be described as present, possible though partially impaired, or absent based on patient report or physiological data, whether available or not ( Table 1). Similarly, the potential for reflex erection is apparently based on the presence of reflex function in the sacral level 2 (S2) to S5 spinal segments [3][4]; however, for purposes of the standards, reflex function is recommended to be described as present, possible though partially impaired, or absent. Because ejaculation is most intimately associated with reproductive functioning, it is documented under reproductive function rather than sexual function.…”

Section: Male Sexual Functionmentioning

confidence: 99%

Development of international standards to document sexual and reproductive functions after spinal cord injury: Preliminary report

Alexander

Bodner

Brackett

et al. 2007

JRRD

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Abstract-Clinicians need standard terminology to communicate effectively about remaining autonomic function in persons after spinal cord injury. This article illustrates the development of standard nomenclature that describes the impact of injury on sexual functioning. A standard anatomic diagnosis and a secondary means of describing the presence of male and female sexual dysfunction, genital arousal, and orgasmic function are discussed.

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Clinical value of combined electrophysiological and urodynamic recordings to assess sexual disorders in spinal cord injured men

Cited by 35 publications

References 41 publications

Effects of level and degree of spinal cord injury on male orgasm

Effects of level and degree of spinal cord injury on male orgasm

Electrophysiological assessment of sexual dysfunction in spinal cord injured patients

Development of international standards to document sexual and reproductive functions after spinal cord injury: Preliminary report

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