[Neurophysiologic techniques in the diagnosis of erectile dysfunction: study of 105 cases]

To present the results of the neurophysiological diagnostic evaluation in patients with erectile dysfunction.

105 consecutive patients with complaints of erectile dysfunction were evaluated. The patients were divided into five groups according to their history: surgery/trauma, diabetes, vascular disease, toxicity, and no antecedents. Neurophysiological examination, laboratory tests, hormone and vascular studies were performed. Patient evaluation included neurophysiological studies on nerve conduction velocity (NCV), bulbocavernosus reflex (BCR), spinal and scalp somatosensory evoked potentials from the posterior tibial nerves (SEPt) and from the dorsal penile nerve (SEPp). In selected cases, electromyography and neuroimaging studies were done.

71 patients (67.62%) showed organic alterations; 57 of these patients had abnormal neurophysiological tests. Ranked in order of incidence, the tests were abnormal for NCV in 46/105 patients, SEPt 37/105, BCR 35/105 and SEPp in 30/105 patients. The incidence of BCR abnormalities was higher than that of the NCV only in the surgery/trauma group, probably due to a higher prevalence of local injuries, while NCV showed the highest incidence of abnormal results in the other groups of patients. Only 8 patients showed normal NCV with abnormal BCR, SEPp and/or SEPt (14.04% of patients had neurophysiological disturbances).

In this study, most of our patients showed vascular, neurologic or both abnormalities, and were rarely associated with other factors. In our view, NCV is the technique of choice in the assessment of neurological disorders in patients with erectile dysfunction, whereas the other less sensitive tests are considered to be indicated basically in erectile dysfunction highly suspected as having an underlying neurogenic cause.