2017 PENILE AUTONOMIC INNERVATION: CORPUS CAVERNOSUM ELECTROMYOGRAPHY REVISITED

Abstract

You have accessJournal of UrologyInfertility: Physiology, Pathophysiology, Basic Research1 Apr 20112017 PENILE AUTONOMIC INNERVATION: CORPUS CAVERNOSUM ELECTROMYOGRAPHY REVISITED Laura Leddy, Xiaogang Jiang, and Claire Yang Laura LeddyLaura Leddy Seattle, WA More articles by this author , Xiaogang JiangXiaogang Jiang Seattle, WA More articles by this author , and Claire YangClaire Yang Seattle, WA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2245AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Electrophysiological measurement of penile autonomic nervous system electrical activity has proven difficult. Corpus cavernosum (CC) electromyography (EMG) was first described in 1989, as a method to measure penile autonomic (sympathetic) innervation. However, interest in the technique waned, in part due to concerns about the origin of the recorded signal. We revisited this technique as a possible tool for the evaluation of neurogenic impotence, which is often a diagnosis of exclusion. Our hypothesis was that the recorded spontaneous and evoked CC potentials derived from the tissue of the corpus cavernosum and not the penile skin. METHODS We recruited healthy male volunteers with normal erectile function confirmed by the International Index of Erectile Function (IIEF). A Porti electrodiagnostic system (TMS International, The Netherlands) connected to a portable computer recorded low-frequency CC-EMG signals via penile surface electrodes during 3 phases: (1) Baseline CC-EMG was recorded for 30 minutes. (2) A penile ring block was performed by injecting subdermally 20cc of 1% lidocaine, followed by 30 minutes of CC-EMG recording. (3) An intracavernosal block using 2cc of 1% lidocaine was injected into the left corporal body, followed by CC-EMG recording for 30 minutes. Alternating startling stimuli, via auditory and median nerve stimulation, were used to evoke penile autonomic signals at random time points during the 3 phases. A suprapubic electrode was used as a control to record sympathetic electrodermal activity. RESULTS Eight healthy male volunteers, ages 19–54 (mean 36) participated. All subjects demonstrated spontaneous and evoked CC-EMG complexes during Phase 1. Evoked CC complexes were preceded by a sharp spike in the penile and suprapubic electrodes. In Phase 2 all subjects had spontaneous and evoked CC complexes. The sharp spike was maintained in the suprapubic electrode but not in the penile electrodes, indicating the skin block eliminated the penile electrodermal response. In Phase 3 no spontaneous or evoked CC complexes or penile electrodermal activity were apparent in any subject, indicating the intracavernosal block eliminated the corporal-generated signal. The suprapubic electrode continued to demonstrate a sharp spike in response to evoking stimuli in all study subjects. CONCLUSIONS This study uses a penile skin block and intracavernosal block to confirm the cavernosal tissue as the source of CC-EMG. Further refinement of this technique may render it useful in the evaluation of neurogenic impotence. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e806-e807 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Laura Leddy Seattle, WA More articles by this author Xiaogang Jiang Seattle, WA More articles by this author Claire Yang Seattle, WA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...