A Case of Acupuncture Therapy for Impotence Caused by Surgery for Rectal Cancer / 全日本鍼灸学会雑誌

We studied the effect of acupuncture on a case of neurogenic impotence caused by surgery for ano-rectal cancer. Acupuncture needles (length: 60mm, diameter: 0.3mm) were inserted into bilateral Zhongliao (BL33) and were stimulated erectrically or rotated manually for 10 minutes. The effectiveness of acupuncture was evaluated by IMP DIARY, which was consisted of the rate of increase on Erectometer, and the changes of the subjective symptoms. We also investigated the effects of acupuncture stimulation on microcirculation of the glans penis. After the treatmeent, IMP DIARY showed improvement of nocturnal penile tumescence, morning erection and erection by masturbation. The microcirculation at the glans penis was increased significantly immediately after acupuncture therapy. From these results, acupuncture treatment to the BL-33 points for neurogenic impotence after surgery for ano-rectal cancer was considered to be useful.

Significant parameters of the bulbocavernosus reflex latency testing for the diagnosis of neurogenic impotence / 대한비뇨기과학회지

Measurement of the bulbocavernosus reflex is widely used to diagnose underlying neurologic disorders in erectile dysfunction. Because this single parameter of latency time in BCRL(bulbocavernosus reflex latency) testing has been used as the sole guideline to diagnose neurogenic impotence, problems in discriminating neurological disturbance from nonneurogenic impotence are frequently encountered especially when the value of latency time is within the borderline range, or when the outcome is difficult to interpret. In order to assess the useful parameters of conventional BCRL testing for the differential diagnosis of neurogenic impotence, we performed BCRL testing in 100 patients who compliance of poor erection. We compared these patients with a previously controlled group of 45 adult males without any erectile or neuronal disturbance. The results obtained were summarized as follows. . 1)Of 100 patients, 24 were diagnosed as neurogenic impotence. 2) In this neurogenic impotence group, as compared to the normal and non-neurogenic impotence group, there was a significant difference(P<0.05) in the values of sensory, pain, reflex threshold and bulbocavernosus reflex latency time. 3) The BCR measurement allowed to find lateralized neurologic disturbance. These results show that in BCRL testing the evaluated values of sensory, pain and reflex threshold, in addition to latency time, can be useful parameters for the differential diagnosis of neurogenic impotence.

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.