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Sacrolumbar intersegmental reflex circuit in men and its relation to the ejaculatory process
Cumhur Ertekin1, Hilmi Uysal, Fikret Bademkiran
1Department of Clinical Neurophysiology, Ege University, Medical School Hospital, Izmir, Turkey. erteker@unimedya.net.tr
Summary
Electrophysiological study reveals sacrolumbar reflex pathways in men. Some patients with premature ejaculation show disturbances in this reflex circuit, potentially impacting ejaculation.
Area of Science:
- Neuroscience
- Urology
- Physiology
Background:
- Understanding the sacrolumbar intersegmental reflex is crucial for male sexual function.
- Previous research has not fully elucidated the electrophysiological pathways involved in ejaculation.
Purpose of the Study:
- To electrophysiologically investigate the intersegmental reflex circuit from sacral to lumbar cord segments.
- To compare these reflex pathways in healthy men, patients with spinal cord injury (SCI), and patients with premature ejaculation (PME).
Main Methods:
- Recorded reflex electromyography (EMG) of cremasteric (CM) and bulbocavernosus (BC) muscles.
- Stimulated upper lumbar and sacral dermatomes using needle electrodes.
- Studied 33 healthy volunteers, 16 patients with SCI, and 26 men with PME.
Main Results:
- Lower sacral dermatomal stimulation (LSS) consistently evoked reflex responses from both CM and BC muscles in controls.
- Upper lumbar dermatomal stimulation (ULS) primarily elicited CM muscle response.
- No significant differences in basic electrophysiological features were observed in SCI patients compared to controls. LSS failed to elicit CM reflex in 39% of PME patients, while BC reflex was preserved.
Conclusions:
- The sacrolumbar intersegmental reflex circuit, reflected in BC and CM muscle activity, is linked to the male ejaculatory process.
- Functional disturbances in this sacrolumbar reflex circuit may be present in some men with PME.
- Further investigation of sacral-to-lumbar dermatome reflex interactions can define electrophysiological mechanisms of ejaculation.
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