Sympathetic skin response in patients with erectile dysfunction

Abstract

classified into three groups of normal or abnormal (increased) latency, and response blocking (no response), the last two being considered pathological conditions. RESULTSIn the penis, the mean ( SD ) SSR% was 52.8 (43.19)% and significantly lower than responses in hands and feet. There was a significant correlation of the SSR% between the palm of the hand and the sole of the foot ( P = 0.01) and between the sole of foot and penis ( P = 0.05). Diabetics showed a significant decrease ( P = 0.001) in the mean SSR% in the palm of the hand and sole of the foot. Although not statistically different, the mean SSR% in the penis was lower in diabetics than in patients with other risk factors for ED. Likewise, the mean SSR% in hand, foot and penis increased with an increase in the International Index of Erectile Function. In the penis, latency was normal ( < 1.5 ms) in 14 and abnormal in 37 patients. There was a significant association between pathological chronic re-innervation in the bulbocavernosus muscle and SSR latencies in the foot ( P = 0.002) and penis ( P = 0.03).Bulbocavernosus muscle electromyography showed a higher frequency of chronic bilateral axonomnesis in patients with abnormal latencies (28%) than in patients with normal SSR latencies in the penis. CONCLUSIONThese results establish an indication of the SSR in patients with ED, registering responses not only in classic locations like the palm of the hand or sole of the foot, but also in the penis. The SSR% was useful as an indicator of the effect on efferent C fibres. Despite SSR being a polysynaptic potential of long latency and regulated by the cerebral cortex, the present results show that it is advisable to record the latencies of SSR in the three areas registered, and especially in the penis, where it seems be more useful as a marker of lumbosacral and/or pudendal alterations.

Sympathetic Skin Response in Patients with Vascular Erectile Dysfunction

“…This result is in line with the previous findings [9,14]. One study reported a significantly lower mean SSR% registered at the penis than that in the hands and feet [14]. Another study evaluated penile SSR (PSSR) in 20 ED patients aged 22 to 55 years (mean: 31 years; 11 cases occurred after pelvic fractures, 3 after severe injury of the perineum, 1 after fracture of the cervical spine, 1 due to hypertension, 2 with a history of severe masturbation, and 2 without known causes) and reported that PSSR in patients with ED had longer latencies and lower amplitudes compared with the control group [9].…”

“…2). This result is in line with the previous findings [9,14]. One study reported a significantly lower mean SSR% registered at the penis than that in the hands and feet [14].…”

“…In a study in 2009, the SSRs of 82 patients with ED were registered (with multiple causes: neurological, diabetes, vascular, psychological, and idiopathic), and the mean SSR% in the hand, foot, and penis increased with an increase in the IIEF-5 score. However, there was no statistical correlation between SSR latencies and the results of the IIEF-5 test [14]. Subjects with pathologic SSR (abnormal SSR latency or absent SSR) in our survey had more severe ED according to their IIEF scores.…”

“…The criteria for considering SSR to be pathologic were as follows: 1) any absent wave; 2) median nerve latency > 1.39 ±0.07 s [17]; 3) tibial nerve latency >1.88±0.11 s [17]; 4) dorsal penile nerve latency >1.5 s [14]. …”

“…It is noninvasive and evaluates sympathetic small-diameter nerve fibers (postganglionic unmyelinated C fibers), which play the main role in erectile function [12,13]. Furthermore, Valles-Antuña et al [14] identified an indication of the SSR in patients with ED and proposed recording responses not only at classic locations such as the palm of the hand or the sole of the foot but also in the penis.…”