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Neuroanatomy and neurophysiology related to sexual dysfunction in male neurogenic patients with lesions to the spinal cord or peripheral nerves

Karel Everaert UGent, WIQ de Waard, Tom Van Hoof UGent, C Kiekens, THOMAS MULLIEZ UGent and Katharina D'Herde UGent (2010) SPINAL CORD. 48(3). p.182-191
abstract
Study design: Review article. Objectives: The neuroanatomy and physiology of psychogenic erection, cholinergic versus adrenergic innervation of emission and the predictability of outcome of vibration and electroejaculation require a review and synthesis. Setting: University Hospital Belgium. Methods: We reviewed the literature with PubMed 1973-2008. Results: Erection, emission and ejaculation are separate phenomena and have different innervations. It is important to realize, which are the afferents and efferents and where the motor neuron of the end organ is located. When interpreting a specific lesion it is important to understand if postsynaptic fibres are intact or not. Afferents of erection, emission and ejaculation are the pudendal nerve and descending pathways from the brain. Erection is cholinergic and NO-mediated. Emission starts cholinergically (as a secretion) and ends sympathetically (as a contraction). Ejaculation is mainly adrenergic and somatic. For vibratory-evoked ejaculation, the reflex arch must be complete; for electroejaculation, the postsynaptic neurons (paravertebral ganglia) must be intact. Conclusion: Afferents of erection, emission and ejaculation are the pudendal nerve and descending pathways from the brain. Erection is cholinergic and NO-mediated. Emission starts cholinergically (as a secretion) and ends sympathetically (as a contraction). Ejaculation is mainly adrenergic and somatic. In neurogenic disease, a good knowledge of neuroanatomy and physiology makes understanding of sexual dysfunction possible and predictable. The minimal requirement for the success of penile vibration is a preserved reflex arch and the minimal requirement for the success of electroejaculation is the existence of intact post-ganglionic fibres. Spinal Cord (2010) 48, 182-191; doi: 10.1038/sc.2009.172; published online 5 January 2010
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (review)
publication status
published
subject
keyword
neuroanatomy, neurophysiology, neurogenic patients, erection, ejaculation, PENILE VIBRATORY STIMULATION, RAT SEMINAL-VESICLE, IN-VIVO EVALUATION, PREMATURE EJACULATION, VAS-DEFERENS, ERECTILE DYSFUNCTION, NEURAL REGULATION, NERVOUS-SYSTEM, MALE-FERTILITY, INJURY
journal title
SPINAL CORD
Spinal Cord
volume
48
issue
3
pages
182 - 191
Web of Science type
Review
Web of Science id
000275194800002
JCR category
REHABILITATION
JCR impact factor
1.826 (2010)
JCR rank
13/42 (2010)
JCR quartile
2 (2010)
ISSN
1362-4393
DOI
10.1038/sc.2009.172
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
945297
handle
http://hdl.handle.net/1854/LU-945297
date created
2010-05-11 10:51:05
date last changed
2010-05-21 15:34:02
@article{945297,
  abstract     = {Study design: Review article.
Objectives: The neuroanatomy and physiology of psychogenic erection, cholinergic versus adrenergic innervation of emission and the predictability of outcome of vibration and electroejaculation require a review and synthesis.
Setting: University Hospital Belgium.
Methods: We reviewed the literature with PubMed 1973-2008.
Results: Erection, emission and ejaculation are separate phenomena and have different innervations. It is important to realize, which are the afferents and efferents and where the motor neuron of the end organ is located. When interpreting a specific lesion it is important to understand if postsynaptic fibres are intact or not. Afferents of erection, emission and ejaculation are the pudendal nerve and descending pathways from the brain. Erection is cholinergic and NO-mediated. Emission starts cholinergically (as a secretion) and ends sympathetically (as a contraction). Ejaculation is mainly adrenergic and somatic. For vibratory-evoked ejaculation, the reflex arch must be complete; for electroejaculation, the postsynaptic neurons (paravertebral ganglia) must be intact.
Conclusion: Afferents of erection, emission and ejaculation are the pudendal nerve and descending pathways from the brain. Erection is cholinergic and NO-mediated. Emission starts cholinergically (as a secretion) and ends sympathetically (as a contraction). Ejaculation is mainly adrenergic and somatic. In neurogenic disease, a good knowledge of neuroanatomy and physiology makes understanding of sexual dysfunction possible and predictable. The minimal requirement for the success of penile vibration is a preserved reflex arch and the minimal requirement for the success of electroejaculation is the existence of intact post-ganglionic fibres. Spinal Cord (2010) 48, 182-191; doi: 10.1038/sc.2009.172; published online 5 January 2010},
  author       = {Everaert, Karel and de Waard , WIQ and Van Hoof, Tom and Kiekens, C and MULLIEZ, THOMAS and D'Herde, Katharina},
  issn         = {1362-4393},
  journal      = {SPINAL CORD},
  keyword      = {neuroanatomy,neurophysiology,neurogenic patients,erection,ejaculation,PENILE VIBRATORY STIMULATION,RAT SEMINAL-VESICLE,IN-VIVO EVALUATION,PREMATURE EJACULATION,VAS-DEFERENS,ERECTILE DYSFUNCTION,NEURAL REGULATION,NERVOUS-SYSTEM,MALE-FERTILITY,INJURY},
  language     = {eng},
  number       = {3},
  pages        = {182--191},
  title        = {Neuroanatomy and neurophysiology related to sexual dysfunction in male neurogenic patients with lesions to the spinal cord or peripheral nerves},
  url          = {http://dx.doi.org/10.1038/sc.2009.172},
  volume       = {48},
  year         = {2010},
}

Chicago
Everaert, Karel, WIQ de Waard , Tom Van Hoof, C Kiekens, THOMAS MULLIEZ, and Katharina D’Herde. 2010. “Neuroanatomy and Neurophysiology Related to Sexual Dysfunction in Male Neurogenic Patients with Lesions to the Spinal Cord or Peripheral Nerves.” Spinal Cord 48 (3): 182–191.
APA
Everaert, K., de Waard , W., Van Hoof, T., Kiekens, C., MULLIEZ, T., & D’Herde, K. (2010). Neuroanatomy and neurophysiology related to sexual dysfunction in male neurogenic patients with lesions to the spinal cord or peripheral nerves. SPINAL CORD, 48(3), 182–191.
Vancouver
1.
Everaert K, de Waard W, Van Hoof T, Kiekens C, MULLIEZ T, D’Herde K. Neuroanatomy and neurophysiology related to sexual dysfunction in male neurogenic patients with lesions to the spinal cord or peripheral nerves. SPINAL CORD. 2010;48(3):182–91.
MLA
Everaert, Karel, WIQ de Waard , Tom Van Hoof, et al. “Neuroanatomy and Neurophysiology Related to Sexual Dysfunction in Male Neurogenic Patients with Lesions to the Spinal Cord or Peripheral Nerves.” SPINAL CORD 48.3 (2010): 182–191. Print.