[Erectile function and urinary function]

Area of Science:

• Neuroscience
• Urology
• Physiology

Context:

• Neuro-urophysiological concepts are rapidly evolving.
• Clinical evaluation of sexual and urinary functions faces continuous changes.
• Accurate interpretation requires understanding current limitations in functional testing.

Purpose:

• To review the evaluation and limitations of clinical investigations for sexual (erection) and bladder (urinary) functions.
• To highlight common problems in functional tests, including standardization and individual sensitivity.
• To examine specific erectile function tests (e.g., penile Doppler, nocturnal penile tumescence, papaverine test, bulbocavernosus reflex) and urinary function tests (e.g., cystometrogram, uroflowmetry, electromyography, urodynamics).

Summary:

• Functional tests for erectile and urinary functions are influenced by advances in neuro-urophysiology.
• Key challenges include the lack of standardized terminology and methodology, and variations in individual sensitivity.
• The review covers established tests like the penile Doppler (AVSS), nocturnal penile tumescence (NPT), papaverine test, and bulbocavernosus reflex (BCR) for erectile function, alongside cystometrogram (CM), uroflowmetry (UFM), electromyography (EMG), and complex urodynamics for urinary function.

Impact:

• Provides a framework for correctly interpreting sexual and urinary function tests in light of evolving neuro-urophysiological understanding.
• Emphasizes the need for standardization to improve the reliability and comparability of functional test results.
• Aids clinicians in recognizing the limitations of various diagnostic tools for erectile and urinary dysfunction, leading to more informed diagnostic and treatment decisions.