Electrophysiological assessment of sexual dysfunction in spinal cord injured patients.

STUDY DESIGN: Survey. OBJECTIVES: To determine associations between sexual dysfunctions and electrophysiological examinations of the genital system in spinal cord injured patients. SETTING: Ege University Hospital, Izmir, Turkey. METHODS: In total, 25 patients (17 men, eight women) who were out of the spinal shock period were examined. Neurological levels were determined according to the American Spinal Injury Association (ASIA) impairment scale. Data about erection, ejaculation and vaginal lubrication were obtained via inquiry forms. Bulbocavernosus reflex (BCR), pudendal somatosensorial evoked potentials (pSEP) and perineal sympathetic skin responses (pSSR) were recorded by an electromyographer unaware of the sexual state or neurological level of the patient. RESULTS: BCRs could be obtained from all patients with lesion levels above the sacral centre. A significant association was found between reflex erection and BCR positivity, while psychogenic erection was shown to have a significant association with the preservation of pSSR in men. Despite the lack of statistical significance due to the small sample size of the women examined, a similar association with lubrication was observed. Ejaculation and orgasm were not shown to be significantly associated with any electrophysiological examination. However, ejaculation was preserved in all men with a lesion level below T12 and with positive pSSR. There was no significant relationship between pSEP and sexual functions. The relationship between the existence of sacral sensation and pSEP positivity was statistically significant. CONCLUSION: This study has proved that BCR and pSSR have an important role in the estimation of the remaining sexual function in spinal cord injured patients. STATEMENT ON ETHICS: We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research.

Postpubertal testicular/epididymal epithelial thickness alterations in unilateral epididymal/vasal obstruction of prepubertal rats.

This study was conducted to evaluate postpubertal testicular and epididymal epithelial changes induced by unilateral epididymal and vasal obstruction in rats by measuring epithelium thickness of seminiferous tubuli (MSTet) and epithelium thickness of ductus epididymis (MDEet). Rats were randomly divided into 3 groups: group I underwent unilateral epididymal ligation; group II underwent unilateral vasal ligation and group III received sham operations. MDEet on the ipsilateral side of the epididymal ligation group significantly decreased compared to the contralateral side and sham group. For the contralateral side of the ligated vas, MDEet significantly decreased compared to the ipsilateral side and sham group. MSTet was less on the side of the operation than the contra lateral side and the sham group after both surgical procedures. The obstruction point of the male genital tract affect sperm parameters for clinical extraction or aspiration procedures.

Central and peripheral motor conduction to cremasteric muscle.

The few electrophysiologic studies of the cremasteric muscle (CM) have mainly been restricted to the cremaster reflex with no reference to central and peripheral nerve conduction to the muscle, probably for technical reasons.Twenty-six normal adult male volunteers were studied by transcranial magnetic cortical stimulation (TMS) and stimulation of thoracolumbar roots. The genitofemoral nerve (GFN) was stimulated electrically at the anterior superior iliac spine and a needle electrode was inserted into the CM for conduction studies. The motor latency to the CM from the cortical TMS ranged from 20 to 33 ms among the subjects (25.8 +/- 2.9 ms, mean +/- SD). Magnetic stimulation of the lumbar roots produced a motor response of the CM within 9.6 +/- 1.9 ms (range, 6-15). The central motor conduction time to the CM was 16.5 +/- 2.8 ms (range, 10-21). Stimulation of the GFN produced a compound muscle action potential with a mean value of 6.4 +/- 1.8 (range, 4-10) ms in 23 of the 26 cases. Thus, central motor nerve fibers to the CM motor neurons exist, and there may be a representation area for the CM in the cerebral cortex. The GFN motor conduction time to the CM may have clinical utility, such as in the evaluation of the groin pain due to surgical procedures in the lower abdomen.