Analyse clinique et neurophysiologique des troubles de la sensibilité pénienne. Étude prospective de 44 cas

Abstract

To precise clinical presentations, pathophysiology and etiologies of penile sensory alteration. Forty-four patients with penile sensory dysfunction underwent clinical and electrophysiological testing with electromyography of bulbocavernosus muscles, study of sacral reflex latencies, somatosensory cortical responses following stimulation of the dorsal nerve of the penis, sensory velocity of the dorsal nerve and pudendal nerve terminal sensory latencies. Penile anesthesia was observed in six (13%) patients, loss of sensibility in 34 (77%), paresthesia in four (9%). Erectile dysfunction was noted in 19 (43%) patients, hypo-orgasmia in seven (16%), cold glans penis sensation in four and loss of spatial sensation during intercourse in three (7%). Abnormalities of electrophysiological perineal testing were observed in 17 (38%) patients. In 27 (62%) cases, no alteration of electrophysiological testing was observed. In 17 (38%) patients, a specific aetiology was founded by means nerve palsy during orthopedic surgery in five cases, entrapment neuropathy following byking in nine cases, two La Peyronie diseases and one diabetes mellitus. In the current series, the prevalence of neuropathy of the dorsal nerve of the penis (that can determine a loss of sensibility) was 40%.