Single potential analysis of corpus cavernosum electromyography seems to be appropriate for distinguishing potent volunteers from patients with erectile dysfunction. Provocation of slow cavernous electric activity seems to be a promising parameter that should be considered for ongoing studies. However, a high range of variation of findings even intra-individually does not currently qualify the method for routine clinical use. Further research will show whether different means of documentation or evaluation, that is corpus cavernosum electromyography pattern analysis at rest after audiovisual sexual stimulation, drug application or digital conversion of data, will lead to better results.

Single potential analysis of corpus cavernosum electromyography seems to be appropriate for distinguishing potent volunteers from patients with erectile dysfunction. Provocation of slow cavernous electric activity seems to be a promising parameter that should be considered for ongoing studies. However, a high range of variation of findings even intra-individually does not currently qualify the method for routine clinical use. Further research will show whether different means of documentation or evaluation, that is corpus cavernosum electromyography pattern analysis at rest after audiovisual sexual stimulation, drug application or digital conversion of data, will lead to better results.

The purpose of this current study was to ®nd out the coincidence of pathological penile vascular supply with pathological data in Bulbocavernosusre¯ex latency (BCR-L) measurements and Pudendal Nerve SSEP (PudSSEP) recordings. Six hundred and sixty-nine males (642 with erectile dysfunction, 27 with different sexual disturbances) (mean age 49.3 y, range 17±76 y) underwent consecutively a battery of neurophysiological investigations together with pharmacotesting of cavernous bodies combined with duplex sonography of penile arteries. Pathological vascular ®ndings were indicated in 286 men (43%), pathological neurophysiological ®ndings in 264 men (39%). Normal ®ndings in both investigations (vascular and neurophysiological) were encountered in 252 men (38%); 131 men (19%) revealed pathological data exclusively in the neurophysiological parameters, 153 (23%) exclusively in the vascular parameters and 133 (20%) in both.The highest percentages of pathological ®ndings were observed in patients with diabetes mellitus (110 out of 131, 88%) and patients who had sustained pelvic trauma or surgery (36 out of 44, 82%), in contrast to the lowest percentage in patients with a proven psychogenic etiology (10 out of 38, 26%). Somewhat surprising was the rather high proportion of vascular impairment in patients with de®ned neurological diseases such as alcohol abuse (20 out of 51, 43%), polyneuropathy (PNP) of various etiology (9 out of 19, 47%), lumbosacral radiculopathies (26 out of 65, 40%), and CNS diseases (24 out of 52, 46%), about half of them coinciding with pathological neurophysiological ®ndings. Even if the validity of BCR-L measurement and PudSSEP recordings in the assessment of neurogenic impotence was controversely discussed, we conclude that in a large number of impotent males both neurogenic and vascular factors are responsible for the onset of erectile dysfunction.

No abstract

Parameters of CC-EMG able to distingiush between healthy controls and men with erectile dysfunction of different etiology in the individual case are currently unknown. Groups of healthy volunteers and men with erectile dysfunction however show significant differences in provocability of slow cavernous electric activity, i.e. if so called "typical single potentials" (tSP) can be recorded already under resting conditions, or only with provocation, or if any activity is missing. In men, who showed tSP already under resting conditions, a significantly higher extent of provoked activity could be assessed as in those, who showed tSP only after provocation. This applies to the number as well as for the extent of the responses to the 3 stimuli valsalva-manoeuvre, arousal and hyperventilation. Patients, who had shown tSP already under resting conditions, were similar to the controls, from whom those, who showed tSP exclusively with provocation differed significantly. Further research will have to prove, if the parameter "provocability" together with the parameter "extent of the provoked cavernous electric activity" might be able to to lead to a better distinction of healthy and pathological situations which would be a precondition for the introduction of the method into clinical use.