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Electrophysiologic Evaluation
Published in Jacques Corcos, Gilles Karsenty, Thomas Kessler, David Ginsberg, Essentials of the Adult Neurogenic Bladder, 2020
Melita Rotar, David B. Vodušek
Neurophysiologically, the bulbocavernous reflex (BCR) is elicited by applying a mechanical, magnetic, or electrical stimulus to the penis/clitoris and recording the activation of the target muscles (bulbospongiosus muscle, EAS) using needle or surface electrodes.13 Electrical stimulation of the dorsal nerve of the penis/clitoris yields two reflex components of the BCR, the first being stable and nonhabituable at latencies about 35 ms, and the second that is more variable and represents a polysynaptic reflex at latencies above 50 ms.14 The only measured parameter of the BCR is the onset latency of the early component (Figure 23.6).15,16
Blocks of Nerves of the Trunk
Published in Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand, Pediatric Regional Anesthesia, 2019
The sensory innervation of the penis is provided mainly by the terminal branch of the pudendal nerves, i.e., the right and left dorsal nerves of the penis. The ilioinguinal (see above) and, in most cases, the genitofemoral nerves contribute fibers to the skin covering the base of the penis.
Pure Autonomic Failure
Published in David Robertson, Italo Biaggioni, Disorders of the Autonomic Nervous System, 2019
Clinical and laboratory testing of erectile function include the evaluation of nocturnal penile tumescence and rigidity, circumferential penile expansion measures, penile blood pressure measures, penile vascular ultrasonography, nerve conduction studies of the dorsal nerve of the penis and measurement of the latency of the bulbocavernosus reflex (Kirby, 1988; Shabsigh, Fishman and Scott, 1988).
Therapeutic potential of Mucuna pruriens (Linn.) on ageing induced damage in dorsal nerve of the penis and its implication on erectile function: an experimental study using albino rats
Published in The Aging Male, 2020
Prakash Seppan, Ibrahim Muhammed, Karthik Ganesh Mohanraj, Ganesh Lakshmanan, Dinesh Premavathy, Sakthi Jothi Muthu, Khayinmi Wungmarong Shimray, Sathya Bharathy Sathyanathan
Penile erection is a complex neurovascular phenomenon. It involves not only the coordination of three hemodynamic events (increased arterial flow, sinusoidal smooth muscle relaxation, and decreased venous drainage) but also the interaction of the brain, nerves, neurotransmitters, smooth and striated muscle, and the tunica albuginea. An alteration in any of these components may decrease the response of the erectile tissue and cause dysfunction [6]. Mechanisms involving vasculogenic and neurogenic factors along with reduced serum testosterone are involved in ED associated with aging [7,8]. Although the molecular mechanisms underlying neurogenic ED are not well understood, the principal theories include impairment in neuronal nitric oxide synthase (nNOS) function and nitric oxide (NO) bioavailability, reduced blood supply to nerve tissue, deficiency of neurohormonal growth factors, and increased oxidative stress [9]. The dorsal nerve of the penis (DNP) is being one of the major sources of nNOS, its integrity is of utmost importance to maintain an erection. Unfortunately, it is often overlooked in the current scenario. The present study focused on the alterations of dorsal nerve of the penis and erectile function in aging male subject and analyzing the therapeutic potential of Mucuna pruriens (M. pruriens) towards controlling the damage to DNP.
One-year follow-up after urethroplasty, with the focus on both lower urinary tract and erectile function
Published in Scandinavian Journal of Urology, 2020
David Míka, Jan Krhut, Kateřina Ryšánková, Radek Sýkora, Libor Luňáček, Peter Zvara
Most previously published studies did not assess the effect of urethroplasty on erectile function. Knowledge of the topographical anatomy of structures (both vascular and neural) involved in erectile function suggests that these may be damaged during urethroplasty. Specifically, risk of damage to the terminal branches of the dorsal artery in the penis, the branches of the dorsal nerve of the penis and the pudendal nerve as has previously been addressed [21]. That is why this study also focused on the evaluation of erectile function after surgical treatment. We observed post-operative improvements in erectile function as measured by the overall IIEF-5 score. This observation has been further supported through interviews during the follow-up visits, where a clinically significant improvement in erectile function after surgery was reported by the majority of the patients. We believe that 12-month follow-up data on erectile function are valid. At this time point the healing after the surgery is completed and the patient can adequately judge the effect of USS on his erectile function. With the longer follow-up we would need to consider age-related deterioration of erectile function. Our results correlate well with previously reported data from the meta-analysis published by Feng et al. [22], indicating that USS does not lead to deterioration of erectile function.
Genital vibration for sexual function and enhancement: a review of evidence
Published in Sexual and Relationship Therapy, 2018
Jordan E. Rullo, Tierney Lorenz, Matthew J. Ziegelmann, Laura Meihofer, Debra Herbenick, Stephanie S. Faubion
The penis contains a variety of superficial and deep nerve receptors that sense changes in pressure, temperature, stretch, and pain. A specific type of sensory mechanoreceptor known as a Pacinian corpuscle plays a prominent role in transduction of vibratory stimulation into afferent neural signals (Tajkarimi & Burnett, 2011). These signals are transmitted along individual nerve fibers, ultimately converging to form the dorsal nerve of the penis (DNP), which runs along the penile shaft. The DNP is a branch of the pudendal nerve (PN). Other branches from the ventral aspect of the penis, scrotum, and perineum also contribute to penile sensation (Everaert et al., 2010; Tajkarimi & Burnett, 2011). Similar to the penis, the scrotum is innervated by distal branches of the PN, which carries sensory information proximally to the spinal cord (Tajkarimi & Burnett, 2011). Vibratory penile nerve stimulation is transmitted to the sacral spinal cord via the PN, where a complex network of inputs from the spinal cord, brainstem, and cerebral cortex takes place (Steers, 2000). Afferent signals from the PN are also transmitted to supraspinal centers involved in higher level processing including the medial preoptic area and paraventricular nuclei within the hypothalamus, thalamus, and even the cerebral cortex (Tajkarimi & Burnett, 2011). Interestingly, several rat studies have shown that oxytocin-mediated neuronal signaling between pudendal afferents, the hypothalamus, and the sacral spinal cord contributes to penile erection (Argiolas, Melis, & Gessa, 1985). Afferents originating from the DNP excite oxytocin cells in the hypothalamic paraventricular nucleus of the rat (Tajkarimi & Burnett, 2011; Yanagimoto, Honda, Goto, & Negoro, 1996).