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Evoked cavernous activity: neuroanatomic implications.

Yilmaz U, Vicars B, Yang CC - Int. J. Impot. Res. (2009)

Bottom Line: All the PS patients had reproducible ECA and SSRs, both preoperatively and postoperatively.There was no difference in the latency and amplitude measurements of ECA and SSRs in the postoperative compared with that of the pre-operative period (P>0.05).In conclusion, ECA is absent in men with SCI above the sympathetic outflow to the genitalia.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, University of Washington, Seattle, WA 98195-6510, USA.

ABSTRACT
We investigated the autonomic innervation of the penis by using evoked cavernous activity (ECA). We recruited seven men with thoracic spinal cord injury (SCI) and sexual dysfunction, and six men who were scheduled to have pelvic surgery (PS), specifically non-nerve-sparing radical cystoprostatectomy. In the PS patients, ECA was performed both pre- and postoperatively. The left median nerve was electrically stimulated and ECA was recorded with two concentric electromyography needles placed into the right and left cavernous bodies. We simultaneously recorded hand and foot sympathetic skin responses (SSRs) as controls. In the SCI group, all but one patient had reproducible hand SSRs. None of these patients had ECA or foot SSRs. All the PS patients had reproducible ECA and SSRs, both preoperatively and postoperatively. There was no difference in the latency and amplitude measurements of ECA and SSRs in the postoperative compared with that of the pre-operative period (P>0.05). In conclusion, ECA is absent in men with SCI above the sympathetic outflow to the genitalia. In men, after radical pelvic surgery, ECA is preserved, indicating the preservation of sympathetic fibers.

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Related in: MedlinePlus

ECA in SCI patient. (2A) Diagram of disrupted ECA reflex and (2B) ECA waveforms. Note the absence of activity in both corpora cavernosa as well as foot SSR. Deflections off the baseline prior to 1 second in the right ECA and foot SSR trace are artefact. Stimulus is delivered at time 0. The time-base is 1 second per division, and the entire trace measures 10 seconds. Amplitude sensitivities are set higher than those in Figure 1.
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Figure 2: ECA in SCI patient. (2A) Diagram of disrupted ECA reflex and (2B) ECA waveforms. Note the absence of activity in both corpora cavernosa as well as foot SSR. Deflections off the baseline prior to 1 second in the right ECA and foot SSR trace are artefact. Stimulus is delivered at time 0. The time-base is 1 second per division, and the entire trace measures 10 seconds. Amplitude sensitivities are set higher than those in Figure 1.

Mentions: In the SCI group, all but one subject had reproducible hand SSRs. This one subject had very dry skin, and thus ECA was not recordable. None of the SCI subjects had foot SSRs or ECA (Figure 2).


Evoked cavernous activity: neuroanatomic implications.

Yilmaz U, Vicars B, Yang CC - Int. J. Impot. Res. (2009)

ECA in SCI patient. (2A) Diagram of disrupted ECA reflex and (2B) ECA waveforms. Note the absence of activity in both corpora cavernosa as well as foot SSR. Deflections off the baseline prior to 1 second in the right ECA and foot SSR trace are artefact. Stimulus is delivered at time 0. The time-base is 1 second per division, and the entire trace measures 10 seconds. Amplitude sensitivities are set higher than those in Figure 1.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4526167&req=5

Figure 2: ECA in SCI patient. (2A) Diagram of disrupted ECA reflex and (2B) ECA waveforms. Note the absence of activity in both corpora cavernosa as well as foot SSR. Deflections off the baseline prior to 1 second in the right ECA and foot SSR trace are artefact. Stimulus is delivered at time 0. The time-base is 1 second per division, and the entire trace measures 10 seconds. Amplitude sensitivities are set higher than those in Figure 1.
Mentions: In the SCI group, all but one subject had reproducible hand SSRs. This one subject had very dry skin, and thus ECA was not recordable. None of the SCI subjects had foot SSRs or ECA (Figure 2).

Bottom Line: All the PS patients had reproducible ECA and SSRs, both preoperatively and postoperatively.There was no difference in the latency and amplitude measurements of ECA and SSRs in the postoperative compared with that of the pre-operative period (P>0.05).In conclusion, ECA is absent in men with SCI above the sympathetic outflow to the genitalia.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, University of Washington, Seattle, WA 98195-6510, USA.

ABSTRACT
We investigated the autonomic innervation of the penis by using evoked cavernous activity (ECA). We recruited seven men with thoracic spinal cord injury (SCI) and sexual dysfunction, and six men who were scheduled to have pelvic surgery (PS), specifically non-nerve-sparing radical cystoprostatectomy. In the PS patients, ECA was performed both pre- and postoperatively. The left median nerve was electrically stimulated and ECA was recorded with two concentric electromyography needles placed into the right and left cavernous bodies. We simultaneously recorded hand and foot sympathetic skin responses (SSRs) as controls. In the SCI group, all but one patient had reproducible hand SSRs. None of these patients had ECA or foot SSRs. All the PS patients had reproducible ECA and SSRs, both preoperatively and postoperatively. There was no difference in the latency and amplitude measurements of ECA and SSRs in the postoperative compared with that of the pre-operative period (P>0.05). In conclusion, ECA is absent in men with SCI above the sympathetic outflow to the genitalia. In men, after radical pelvic surgery, ECA is preserved, indicating the preservation of sympathetic fibers.

Show MeSH
Related in: MedlinePlus