Penile Erection Following Complete Spinal Cord Injury in Man

Chapelle, P; Durand, Jean‐Claude; Lacert, P

doi:10.1111/j.1464-410x.1980.tb02962.x

Cited by 113 publications

(48 citation statements)

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“…Because SSR from the feet and genitals are transmitted via the TL pathway 9,10 and because the TL pathway is also involved in the transmission of psychogenic erection, 28,30 it was believed that SSR results from the feet and genitals would re¯ect the integrity of the TL pathway and would therefore be associated (in the same subject) with maintenance of psychogenic erections. The study also considered lesion levels, since higher lesions were expected to interrupt the necessary connections for SSR transmission in the feet and genitals, and to interrupt the necessary connections for the transmission of psychogenic erections.…”

Section: Discussionmentioning

confidence: 99%

Sympathetic skin responses and psychogenic erections in spinal cord injured men

et al. 1998

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Sympathetic skin responses (SSR) are a simple procedure to investigate sympathetic activity. More speci®cally, SSR elicited from median nerve stimulation and recorded from the feet and genitals assess sympathetic activity resulting from thoracic-lumbar (TL) innervation. Since TL innervation is also involved in the mediation of psychogenic erection in spinal cord injured men, this study investigated the relationship between SSR and psychogenic erection in spinal cord injured subjects. The results support a general association between SSR and psychogenic erection and show that subjects who maintain SSR responses in the feet and genitals generally maintain psychogenic erections as well. Inconsistent cases are discussed from a theoretical and clinical perspective and overall results are discussed in terms of their clinical application in the evaluation of sexual function in spinal cord injured men.

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Section: Discussionmentioning

confidence: 99%

Sympathetic skin responses and psychogenic erections in spinal cord injured men

et al. 1998

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“…Whereas in healthy men, the parasympathetic sacral erection centre seems to play a major role in producing reflexive and psychogenic erections as well as nocturnal erections, our NPTR findings corroborate the observation that many men with lesion of the sacral conus maintain sympathetic induced pyschogenic and nocturnal erections. 11,13,26,27 Whether this phenomenon is due to a neuronal plasticity process in a still intact thoracolumbar centre, which then assumes a compensatory proerectile function, remains to be proven. Transection and stimulation experiments of the hypogastric nerve (HGN) in animals showed controversial results.…”

Section: Discussionmentioning

confidence: 99%

Nocturnal penile tumescence and rigidity (NPTR) findings in spinal cord injured men with erectile dysfunction

2004

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This prospective study aimed at determining whether nocturnal penile tumescence and rigidity (NPTR) findings correlate to the neurologic disorders in spinal cord injured (SCI) patients suffering from erectile dysfunction (ED). A total of 25 acute SCI male patients with post-traumatic ED underwent neurological, electrophysiological and urodynamic examinations, respectively, as well as NPTR recordings. The mean value for rigidity (R), tumescence (T) and duration (D) during NTPR tests were 83.3%, 3.3 cm, 6.4 min in patients with a complete lesion above the sacral (S2-S4) spinal cord (n ¼ 10), 46.1%, 1.6 cm, 5.5 min in patients with a complete lesion involving the sacral metameres (n ¼ 5) and 89.8%, 3.8 cm, 29 min in patients with an incomplete suprasacral lesion (n ¼ 7). The differences among these groups were statistically significant (Po0.05). Patients with lesions involving both sacral and thoracolumbar spinal cord showed no erections (n ¼ 3). We found four NTPR patterns: (1) normal R and T, short D; (2) weak R and T, short D; (3) normal R, T and D; and (4) no erections, which can be assigned to different levels and completeness of spinal cord lesions. Nocturnal erections of normal quality need preservation of thoracolumbar and sacral neuronal control as well as partially intact connections of the spinal erection centres with brain areas responsible for sexual arousal.

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“…No such`psychogenic' erections occurred in patients with lesions above T9. 20,21 Based on these observations, the efferent out¯ow involved in psychogenic erection was suggested to leave the spinal cord at the levels T11 and T12. 21 Re¯exogenic erections remained intact if the sacral cord or conus medullaris was undamaged.…”

Section: Sympathetic Pathways To the Penismentioning

confidence: 99%

“…20,21 Based on these observations, the efferent out¯ow involved in psychogenic erection was suggested to leave the spinal cord at the levels T11 and T12. 21 Re¯exogenic erections remained intact if the sacral cord or conus medullaris was undamaged. Electrical stimulation of the intact hypogastric plexus by a surgically implanted device consistently caused erectile responses.…”

Section: Sympathetic Pathways To the Penismentioning

confidence: 99%

Sympathetic pathways and adrenergic innervation of the penis

2000

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The sympathetic nervous system is important for penile function: it mediates detumescence and may contribute to the maintenance of the penis in a non-erect state. The sympathetic preganglionic neurons are found in the intermediolateral gray matter of the spinal cord. Postganglionic neurons are located to the sympathetic chain ganglia, the inferior mesenteric, hypogastric and pelvic ganglia, and possibly to ganglia near the target organ. Sympathetic ®bres can be found in the pelvic, cavernous, and pudendal nerves. Stimulation of the sympathetic pathways to the penis may, however, also produce erection. It has been suggested that the suprasacral vasodilator pathway is a sympathetic cholinergic pathway, operating through cholinergic neurons in the pelvic plexus. In the penis, there is a rich sympathetic, adrenergic innervation of the corpus cavernosum (CC) and the vasculature, and in particular of the helicine arteries. Sympathetic, adrenergic nerves also contain neuropeptide Y. Parasympathetic cholinergic nerves, which mediate CC relaxation and erection, contain not only acetylcholine, but also vasoactive intestinal polypeptide, nitric oxide synthase, and probably other mediators andaor mediator-synthesizing enzymes. Activation of sympathetic adrenergic nerves causes release of noradrenaline, acting on a-adrenoceptors in the trabecular smooth muscle of the CC and in penile vessels. The role of interactions between different transmitters and mediators, released from nerves or generated locally, in the regulation of contraction and relaxation of CC and penile vessels, needs further study.

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Penile Erection Following Complete Spinal Cord Injury in Man

Cited by 113 publications

References 0 publications

Sympathetic skin responses and psychogenic erections in spinal cord injured men

Sympathetic skin responses and psychogenic erections in spinal cord injured men

Nocturnal penile tumescence and rigidity (NPTR) findings in spinal cord injured men with erectile dysfunction

Sympathetic pathways and adrenergic innervation of the penis

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