Bulbocavernosus reflex studies and autonomic testing in the diagnosis of erectile dysfunction

Journal of the Neurological Sciences
S J Bird, P M Hanno

Abstract

The electrophysiologic evaluation of patients with erectile dysfunction presents an important diagnostic challenge. The bulbocavernosus reflex (BCR) latency has been commonly used to evaluate these disorders. However, it is a measure of somatic penile innervation, whereas erection is primarily dependent on autonomic function. We evaluated 195 men with erectile dysfunction over a 3 year period. Each had electrophysiologic studies, nerve conduction studies and a BCR. BCR studies were abnormal in only 7%, of which most had diabetes or pelvic trauma. The BCR was the sole electrophysiologic abnormality in only 2%. Autonomic testing (AT) was additionally performed in 19 diabetic and 23 non-diabetic patients. This included sympathetic skin responses and measurement of the Valsalva ratio and heart rate variability with 6/min breathing. In the diabetic group, AT was positive in 63%, and most often was the sole abnormality. The bulbocavernosus reflex is relatively insensitive in the diagnosis of erectile dysfunction. Brief autonomic testing may provide valuable additional data, particularly in diabetics.

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Citations

Jan 5, 2002·Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society·T F Lue
Mar 21, 2006·Research in Veterinary Science·E Turan, O Bolukbasi
Apr 19, 2005·Urology·Clifford B BleusteinArnold Melman
Dec 3, 2010·Urologia Internationalis·Edmundo Pereira de Souza NetoXavier Martin
Dec 8, 2017·Okajimas Folia Anatomica Japonica·Shinichi AbeMurakami Gen
May 30, 2014·The World Journal of Men's Health·Mostafa JazayeriAmirhooshang Vahedi
Dec 21, 2002·International Journal of Impotence Research·C B BleusteinA Melman
Nov 4, 2005·Neurourology and Urodynamics·Christina-Anastasia RapidiCharalambos Theodorou
Jun 14, 2001·The Urologic Clinics of North America·A Nehra, R B Moreland

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