AI Article Synopsis

  • Diagnostic tests for vascular erectile dysfunction (ED) depend on the relaxation of cavernous smooth muscles (CSM) after intracorporal injections, but sympathetic tone can affect results, making CC-EMG a useful new diagnostic tool for assessing CSM integrity.
  • The study involved 24 men with ED who had negative responses to injections and 10 healthy controls, using penile CDDU exams and CC-EMG recordings to analyze results.
  • Significant differences were found in CSM activity, particularly in patients with veno-occlusive diseases (VOD), indicating that CC-EMG could help identify CSM impairments and guide treatment options for ED.

Article Abstract

Introduction: Diagnostic tests for vascular erectile dysfunction (ED) depend on cavernous smooth muscles (CSM) relaxation following an intracorporal injection (ICI). Enhanced sympathetic tone, which is not uncommon during performance of these tests, can bias its results. Also, CSM diseases can cause veno-occlusive diseases (VOD) ED. Corpus cavernosum electromyography (CC-EMG) potentials' amplitudes represent the integrated sympathetic activity of healthy CSM. Stem-cells and gene-therapy are potential therapeutic options for impaired CSM.

Objective: To utilize CC-EMG, as a new diagnostic technique that can confirm the integrity of CSM, and to identify patients with impaired CSM activity, among those diagnosed as vascular ED per Color Duplex Doppler Ultrasonography (CDDU).

Patient And Methods: Group 1 included 24 patients with ED and negative response to ICI. Group 2 included 10 men without ED. Patients included in group 1 had penile CDDU examination and all participants had spontaneous CC-EMG recordings.

Results: According to CDDU parameters, group 1 was sub-grouped as nine arterial, ten VOD and five mixed type. CC-EMG potentials' amplitudes ranged 223-320, 179-237, 103-250 and 83-200μV for group 2 and arterial, mixed and VOD subgroups respectively. The widest ranges of potentials' amplitudes were recorded in the subgroups of patients with an element of VOD. Four patients with ED, within these subgroups, had CC-EMG potentials' amplitudes ranged 200-250μV that exceeded/approached the lowest value recorded from men in group 2.

Conclusion: CC-EMG recordings elicited marked differences of CSM activity among patients diagnosed with an element of VOD ED per CDDU. This finding highlighted the need to utilize CC-EMG to assess the integrity of CSM. Identifying patients with impaired CSM activity may modify the chosen methods for therapeutic interventions.

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http://dx.doi.org/10.1016/j.androl.2017.11.001DOI Listing

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