Characteristics of Bulbocavernous Reflex Latency Test and Dorsal Nerve Somatosensory Evoked Potential Test in Patients with Premature Ejaculation

BACKGROUND: Though its cause has not been well established, premature ejaculation is the most prevalent form of male sexual dysfunction. Some recent studies suggest that penile hypersensitivity and hyperexcitability, earlier excitation of the sacral reflex arc, and abnormality with peripheral and central afferent nerve conduction pathways, are related to premature ejaculation. METHODS: The bulbocavernous reflex latency (BCRL) test and dorsal nerve somatosensory evoked potential (DNSEP) test were done in 15 normal subjects (mean age: 38.2 years) and 30 premature ejaculation patients (mean age: 40.2 years) without history of neurological disorders nor history of medication which influences the nervous system. RESULTS: The mean latency of BCR was shortened significantly in patients with premature ejaculation (33.1+/-3.08 msec) than in the control group (37.2+/-3.95 msec)(P<0.01). However, there were no significant differences in latency and amplitude of DNSEP tests between the two groups. CONCLUSIONS: Based on our results, the earlier excitation of the sacral reflex arc might be related to premature ejaculation. (J Korean Neurol Assoc 19(5):494~497, 2001)

Efficacy of Oral Pharmacotherapy according to Results of Biothesiometry, BCRL and DNSEP in Patients with Premature Ejaculation / 대한비뇨기과학회지

PURPOSE: To determine whether biothesiometry, bulbocavernous reflex latency(BCRL), and dorsal nerve somatosensory evoked potential(DNSEP) test could predict efficacy of tricyclic antidepressant(TCA) or selective serotonin reuptake inhibitor(SSRI) to prolong the ejaculatory latency in premature ejaculation. MATERIALS AND METHODS: A total of 33 patients with pramature ejaculation(mean age: 44 years) completed the entire study, Patients took each of clomipramine(50mg), sertraline(1 00mg), and fluoxetine(40mg) consecutively during a 4-week period per each agent. We obtained increased intravaginal ejaculatory latency by the most effective drug among 3 drugs. We analyzed correlations of the increased intravaginal ejaculatory latency with vibration threshold of penile shaft and glans, BCRL, and latency and amplitude of DNSEP. RESULTS: According to Pearson's correlation analysis, there was no correlation of intravaginal ejaculatory latency with vibration threshold of penile shaft and glans, BCRL, and latency and amplitude of DNSEP(all p> 0.05). There was no difference in intravaginal ejaculatory latency between the groups of high and low vibration threshold, long and short BCRL, long and short latency of DNSEP, and large and small amplitude at cerebral cortex on DNSEP test(all p> 0.05). CONCLUSIONS: It seems that biothesiometry, BCRL, and DNSEP test can not predict the efficacy of tricyclic antidepressant or selective serotonin reuptake inhibitor to prolong the ejaculatory latency in premature ejaculation.

The Value of Bulbocavernosus Reflex Latency and Dorsal Nerve Somatosensory Evoked Potential in Diagnosis of Neurogenic Impotence / 대한비뇨기과학회지

Bulbocavernosus reflex latency (BCRL)and dorsal nerve somatosensory evoked potential (DNSEP)are used widely to diagnose underlying neurogenic disorders. Because these methods evaluate somatosensory nerve system and neurophysiology of the erectile process has not yet been satisfactorily clarified, it could be worthwhile to investigate the validity of these two. The BCRL and DNSEP were recorded in 89 subjects and 18 had abnormal results. Out of 18 patients, 8 and 16 had abnormal BCRL and DNSEP, respectively. Three of 8 patients with abnormal BCRL and six of 16 with abnormal DNSEP were diagnosed psychogenic impotence as confirmed by audiovisual stimulation-penogram and nocturnal penile monitoring. Our study suggests that these methods may not be conformable to establish the diagnosis of neurogenic erectile failure and to use screening test for underlying neurogenic disorders.

The Bulbocavernosus Reflex Latency in Normal Korean Adult Males / 대한비뇨기과학회지

The Bulbocavernous reflex is important in the neurological evaluation of patients with impotence or neurogenic bladder. Classically, this reflex has been elicited and estimated by manual stimulation of glans penis or clitoris. However, it is extremely subjective and minimal degrees of neuronal dysfunction cannot be detected. We have applied electrophysiologic testing technique to quantitative this reflex more objectively and to prepare normal data for the pathologic states. There were 15 adult male subjects without erectile disturbance and neuronal dysfunction studied by the electromyographic testing technique. The stimuli were delivered to the ipsilateral and contralateral penile shaft with a frequency of 1/sec., a pulse duration of 0.5 msec. and averaging of 64. The Results obtained were summarized as follows: 1. Mean BCR latency was 35.6+/-1.6 msec. (28-45 msec.), and showed no statistical difference(p>0.5) among the value of different age groups. Ipsilateral and contralateral responses varied from each other by not > 2 msec. 2. Mean sensory threshold was 20 V (15-25 V), and showed no statistical difference(p>0.5) among the values of different age groups. 3. Mean pain threshold was 45 V (35-80 V), and showed no statistical difference(p>0.5) among the values of different age groups. 4. Mean reflex threshold was 40 V (30-60 V), and showed no statistical difference(p>0.5) among the values of different age groups. 5. In entire age groups, the latency diminished slightly as the stimulating voltage was increased.