Skin potentials (SP) were evoked by peripheral nerve stimulation from the hands and feet of 41 and from the genital skin of 28 male, controls. The same methods were also applied in 10 functionally impotent cases, 32 diabetic impotent and 8 diabetic normopotent cases. The SP was easily obtained from all 3 sites in all normal subjects and in 10 functionally impotent cases. The SP recorded from the genital skin was either absent or abnormal in 53% of diabetic impotent cases with or without polyneuropathy, while the incidence of abnormalities encountered in the hand and/or foot recordings was 28%. In 8 diabetic normopotent cases the SP recorded from the genital and extremity skin were completely normal. SP recorded from the genital skin is a useful method of evaluating the autonomic-sympathetic dysfunction causing impotence, especially in patients who may have autonomic disorders either located in lumbosacral spinal cord and its efferents, or generalized autonomic-peripheral dysfunction.

SYNOPSISThe conduction velocity along the nociceptive flexor reflex afferent nerve fibres was investigated in human subjects. The posterior tibial nerve was stimulated at two sites by single painful electrical shocks of 1.0 ms duration and with adequate intensity and the reflex EMG discharges were recorded from the short head of the biceps femoris muscle. The fastest reflex conduction velocity along the posterior tibial nerve between the ankle and the popliteal fossa was about 10-25 m/s. Thus the fastest flexor reflex afferent fibres associated with a painful sensation were thought to be included in the A-delta group of cutaneous afferent nerve fibres.

Sympathetic skin potentials (SSP) were evoked by peripheral nerve stimulation of the hands, feet, and genital skin of 49 diabetics with erectile impotence. Eight potent diabetic men were used as controls. The bulbocavernosus reflex latency (BCR) was also recorded from all patients. The BCR was prolonged in 31% of impotent patients, while the SSP were absent in the genital skin in 47%. Fifty nine percent had either prolonged BCR or absent SSP. In 12 patients with "subacute impotence" the electrophysiological findings were abnormal in 10 (83%). In 37 patients with slowly progressive impotence, 51 % had electrophysiological abnormalities.It was concluded that pelvic-autonomic neuropathy i s one of the major contributing factors in the pathogenesis of diabetic erectile impotence, especially in the subacutely developing cases; however, neuropathic and vascular factors probably both play a part in the pathogenesis of impotence in the majority of cases with a slowly progressive course.

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Fifteen chronic alcoholic male patients with impotence have been investigated with the electrophysiological method of sympathetic skin potentials recorded from the genital skin and with the electrically induced bulbocavernosus reflex. Both electrophysiological tests did not differ from those of normal controls. It was proposed that there is no obvious role of the peripheral neuropathic factors in the pathogenesis of impotence in chronic alcoholism.