Sympathetic Skin Response in Patients with Vascular Erectile Dysfunction

PURPOSE: We aimed to investigate the utility of sympathetic skin response (SSR) test for evaluating vasculogenic erectile dysfunction (ED) which is the most common type of impotence. MATERIALS AND METHODS: Men in the age group of 28 to 60 years and suffering from vasculogenic ED, as confirmed by a papaverin test and color Doppler sonography, at least for 6 months referred from our university urology department were included. We used the International Index of Erectile Function (IIEF-5) for grading severity of dysfunction and recorded the SSR of every patient from the median, tibial, and dorsal nerves of the penis. One-way analysis of variance (ANOVA), independent t-test and Pearson's correlation coefficient were used for comparing quantitative variables, and Fisher's Exact test was used for comparing qualitative variables. The Mann-Whitney U Test and the Kruskal-Wallis test were performed for analysis of data that were not normally distributed. A p value of less than 0.05 was considered significant. RESULTS: Forty-two patients were recruited for the study. We found a strong statistical relationship between the IIEF score and the pathologic SSR registered from every mentioned nerve. Patients with abnormal SSR had more severe ED according to IIEF score (p<0.001). In addition, the IIEF score had a significantcorrelation with diabetes mellitus and cardiovascular disease (t-test; p<0.05). CONCLUSIONS: Our results confirmed the presence of autonomic dysfunction in patients with vasculogenic impotence via an SSR test. We suggest evaluating the efficacy of the SSR test in patients with vascular impotence for treatment response monitoring in future studies.

[Sympathetic skin response in chronic renal failure patients]

Background and Aim: uremic neuropathy is one of the most common complications of chronic renal failure. Autonomic neuropathy occurs in addition to peripheral somatic system involvement. Sympathetic skin response [SSR] is a simple noninvasive test for evaluation of skin's eccrine sweat glands activity in response to sympathetic stimulation. Pathway of this sympathetic response contains afferent myelinated fibers, central part and efferent unmyelinated sympathetic fibers

Method: in this study SSR test was performed on 31 patients with chronic renal failure on regular hemodialysis and 35 normal controls

Results: SSR was absent in 12 patients [38.7%] and abnormal in 23 patients [74%]. No good correlation was found between abnormal SSR and clinical dysautonomic symptoms, but it seems that SSR becomes abnormal long before appearance of clinical dysautonomic symptoms in chronic renal failure. Age, Sex, duration of hemodialysis and duration of history of renal failure had no effect on SSR, but SSR seems to be affected by high weekly frequency of hemodialysis

Conclusion: so we concluded that in chronic renal failure peripheral sympathetic system involvement is common and adequate dialysis has effect on its progression