Introduction and Objectives
Evaluate bulbocavernous and external anal sphincter muscles with needle EMG patients with neurogenic erectile dysfunction, 6–12 month after radical prostatectomy.
Material and Methods
The investigation of 14 patients with erectile dysfunction included vascular, hormonal, general and neurological examination, needle EMG analysis of pelvic floor muscles. In all patients MUPs mean amplitude and duration, muscle fibers spontaneous activity (FP and PSW) were evaluated.
Motor and sensory deficit was revealed in 2 patients with herniated disc spondylotomy and 1 had spinal stroke; the rest 8 patients have no neurological disturbances. In 5 patients significant asymmetry of MUPs recruitment pattern and single-sided amplitude and duration decay accompanied by denervation activity (FP) was found. Spontaneous activity (FP and PSW) without sings of reinnervation was observed in 4 patients. In 6 patients moderate polyneuropathy with decreased limb and pudendal nerve conduction was found. In 1 patient the vegetative neuropathy was proved. In consideration of neurogenic dysfunction of pelvic floor muscles an additional active therapy was started. Erectile dysfunction symptoms (erection quality, rate of spontaneous erectile activity, sensitivity of external genitalia) were improved within 3–6 months.
Our results suggest the importance of pelvic floor muscles innervation status in patients with erectile dysfunction, from patients after RP. The pelvic floor muscles dysfunction should be considered an important component of erectile dysfunction pathogenesis and its improvement requires specific management.
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.