Neurophysiological Evaluation of Erectile Dysfunction

Abstract

Diagnosing the neurogenic causes underlying erectile dysfunction represents a special challenge within the framework of a complete multidisciplinary evaluation of impotency. Neurogenic disturbances that result in erectile dysfunction can be caused by lesions in the autonomic nervous system or within somatic nerve fibers. Only indirect evaluation of the autonomic nervous system is clinically possible. Lesions ascribed to the somatic nervous system can be easily measured and recorded using routine diagnostic methods [1–7, 9, 14, 15]. Measurement of the latency times of the bulbocavernous reflex (BCR) and somatosensory evoked potentials (SSEP) after stimulation of the dorsal penile nerve are proven clinical neurological tests, which are performed routinely [7, 16]. Recording of the bulbocavernous reflex after cortical magnetic stimulation [8], sleep polygraphy and late somatosensory evoked potentials (LSSEP) of the dorsal penile nerve are further methods used in the diagnosis of central nervous system disturbances responsible for erectile dysfunction [10].