Abstract
Neurophysiologically, penile erection is elicited by two different mechanisms and mediated by somatic and autonomic pathways. Psychogenic erections, initiated in supraspinal centers in response to auditory, visual, olfactory, and imaginative stimuli, are mediated by sympathetic pathways. Reflexogenic erections, elicited by tactile stimulation at the genital level, are mediated by a spinal reflex arc consisting of afferent somatic and efferent parasympathetic nerve fibers. Therefore, the neurological factor in erectile dysfunction (ED) may include central and peripheral neural structures (Andersson and Wagner, 1995; Giuliano et al, 1995). The ideal neurourophysiological assessment will objectively and quantitatively evaluate the functional status of all parts of this neurological network. In the last two decades, a series of tests has been developed, each of which reflects a specific part of the network. This review gives a brief overview of neuroanatomy and physiology of the erectile response and focuses on current applicability of neurophysiological tests for evaluating the integrity of the nervous system involved in erectile function.
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