Innervation of the human anterior urethra by the dorsal nerve of the penis

Yang, Claire C.; Bradley, William E.

doi:10.1002/(sici)1097-4598(199804)21:4<514::aid-mus10>3.0.co;2-x

Cited by 16 publications

(3 citation statements)

References 10 publications

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“…The BC muscle is a paired, striated muscle surrounding the bulbous urethra, which has been reported to be closely related to ejaculation by its clonic contractions and other perineal muscles to expel the semen from the urethra [29–31]. Its contraction could be evoked by stimulation of penile skin, anterior urethra, and posterior urethra [26,32,33]. Innervation of penile skin and anterior urethra is penile dorsal nerve (somatic nerve).…”

Section: Discussionmentioning

confidence: 99%

Bulbocavernosus Reflex to Stimulation of Prostatic Urethra in Patients with Lifelong Premature Ejaculation

Zhou

Jiang

Zhang

et al. 2010

The Journal of Sexual Medicine

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Introduction Lifelong premature ejaculation (LPE) is a prevalent sexual dysfunction among men, while its precise pathologic mechanisms have remained poorly understood. Aim In our study, the correlation between excitability of bulbocavernosus reflex (BCR) to stimulation of the prostatic urethra and LPE was studied. Methods Twenty normal potent male volunteers and 42 patients with LPE were studied by inserting a specially designed Foley catheter with two electrodes mounted on its distal surface (intraurethral catheter electrode) into bladder to evoke the BCR to stimulation of prostatic urethra. Also, sensitivity of glans penis to electrical stimulation was detected by two surface electrodes. Main Outcome Measures Sensory thresholds of BCR to stimulation of prostatic urethra, thresholds to evoke stable BCR, latencies of BCR, and sensory thresholds of glans penis to electrical stimulation. Results The mean sensory thresholds of BCR to stimulation of prostatic urethra, thresholds to evoke stable BCR, latencies of BCR, and sensory thresholds of glans penis were 12.38 ± 3.71 mA (0.2 ms in duration,1 Hz), 23.81 ± 5.55 mA (0.2 ms, 1 Hz), 70.48 ± 6.33 ms, and 11.89 ± 2.26 mA (0.04 ms in duration,3 Hz) in the patients with LPE, respectively, and were 18.20 ± 2.68 mA (0.2 ms, 1 Hz), 34.76 ± 4.15 mA (0.2 ms, 1 Hz), 71.20 ± 5.77 ms, and 14.16 ± 1.94 mA (0.04 ms, 3 Hz) in the normal potent men, respectively (mean ± SD). Statistically significant differences were seen regarding the sensory thresholds of BCR to stimulation of prostatic urethra, the thresholds to evoke stable BCR and the sensory thresholds of glans penis between the two groups (P <0.001). No statistically significant differences were seen regarding the latencies of BCR between the two groups (P > 0.05). Conclusions Patients with LPE might have hyperexcitable BCR to stimulation of prostatic urethra, which is probably one of the important factors for its etiology.

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Section: Discussionmentioning

confidence: 99%

Bulbocavernosus Reflex to Stimulation of Prostatic Urethra in Patients with Lifelong Premature Ejaculation

Zhou

Jiang

Zhang

et al. 2010

The Journal of Sexual Medicine

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“…Insertion of a lubricated urethral self-catheter into the midurethra tests the integrity of the pudendal and pelvic nerves. 18 The patient underwent this procedure including administration of sterile saline 5-10 mL into the urethra. He reported being very aware of the pain in addition to discomfort from urethral distension.…”

Section: Case Reportmentioning

confidence: 99%

A Novel Collaborative Protocol for Successful Management of Penile Pain Mediated by Radiculitis of Sacral Spinal Nerve Roots From Tarlov Cysts

Goldstein

Komisaruk

Rubin³

et al. 2017

Sexual Medicine

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IntroductionSince 14 years of age, the patient had experienced extreme penile pain within seconds of initial sexual arousal through masturbation. Penile pain was so severe that he rarely proceeded to orgasm or ejaculation. After 7 years of undergoing multiple unsuccessful treatments, he was concerned for his long-term mental health and for his future ability to have relationships.AimTo describe a novel collaboration among specialists in sexual medicine, neurophysiology, and spine surgery that led to successful management.MethodsCollaborating health care providers conferred with the referring physician, patient, and parents and included a review of all medical records.Main Outcome MeasureElimination of postpubertal intense penile pain during sexual arousal.ResultsThe patient presented to our sexual medicine facility at 21 years of age. The sexual medicine physician identifying the sexual health complaint noted a pelvic magnetic resonance imaging report of an incidental sacral Tarlov cyst. A subsequent sacral magnetic resonance image showed four sacral Tarlov cysts, with the largest measuring 18 mm. Neuro-genital testing result were abnormal. The neurophysiologist hypothesized the patient's pain at erection was produced by Tarlov cyst-induced neuropathic irritation of sensory fibers that course within the pelvic nerve. The spine surgeon directed a diagnostic injection of bupivacaine to the sacral nerve roots and subsequently morphine to the conus medullaris of the spinal cord. The bupivacaine produced general penile numbness; the morphine selectively decreased penile pain symptoms during sexual arousal without blocking penile skin sensation. The collaboration among specialties led to the conclusion that the Tarlov cysts were pathophysiologically mediating the penile pain symptoms during arousal. Long-term follow-up after surgical repair showed complete symptom elimination at 18 months after treatment.ConclusionThis case provides evidence that (i) Tarlov cysts can cause sacral spinal nerve root radiculitis through sensory pelvic nerve and (ii) there are management benefits from collaboration among sexual medicine, neurophysiology, and spine surgery subspecialties.Goldstein I, Komisaruk BR, Rubin RS, et al. A Novel Collaborative Protocol for Successful Management of Penile Pain Mediated by Radiculitis of Sacral Spinal Nerve Roots From Tarlov Cysts. Sex Med 2017;5:e203–e211.

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“…From a diagnostic perspective, DSM-IV defi nes PE as reaching orgasm within 1 minute of penetration. However, researchers have used various ways to defi ne PE using time to orgasm after penetration (1-7 min), number of thrusts to orgasm (8)(9)(10)(11)(12)(13)(14)(15), and the inability of the female partner to gain pleasure at least 50% of the time [ 16 ]. With the possible approval of the fi rst approved drug for PE, there has been an increasing interest in self-report defi nitions of PE that revolve around patient control and patient and partner distress.…”

Section: Premature Ejaculationmentioning

confidence: 99%

The role of psychological treatment strategies in ejaculatory dysfunction

Nelson

2008

Curr sex health rep

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Innervation of the human anterior urethra by the dorsal nerve of the penis

Cited by 16 publications

References 10 publications

Bulbocavernosus Reflex to Stimulation of Prostatic Urethra in Patients with Lifelong Premature Ejaculation

Bulbocavernosus Reflex to Stimulation of Prostatic Urethra in Patients with Lifelong Premature Ejaculation

A Novel Collaborative Protocol for Successful Management of Penile Pain Mediated by Radiculitis of Sacral Spinal Nerve Roots From Tarlov Cysts

The role of psychological treatment strategies in ejaculatory dysfunction

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