Skip to main content
SpringerLink
Log in

Corpus cavernosum electromyography (CC-EMG): A new technique in the diagnostic work-up of impotence

  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

We have studied cavernous electrical activity in 42 subjects, healthy volunteer controls and groups of impotent, patients using a nonspecific electromyographic device (PICO-MENFIS) and a specific one, the SPACE-recorder 7500 designed to achieve electric recordings from the corpora cavernosa. In all of the patients, we detected under basal conditions a mean amplitude of 583±323 μV, a mean duration of 4.9±7 s,a mean polyphasicity of 3.5±1.4. It should be emphasized that a significant reduction of potential amplitudes was recorded after pharmacological stimulation in both the controls and the impotent patients. The healthy controls showed amplitudes significantly higher than the impotent patients after radical cystectomy (715±141 μV versus 381±227 μV, p<0.01).

The patients after a “nerve-sparing” radical cystectomy with a mean amplitude similar to the controls (500–700 μV) reacted well to the intracavernous drugs in a high percentage of cases.

In our experience, CC-EMG seems to be a reliable method which can pinpoint directly lesions to the cavernous smooth muscle and penile autonomic nerves. It has also been able to assess the effects of stress, anxiety and pain on the erectile mechanisms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Goldstein, J.: Evaluation of the penile nerves. In: Contemporary Management of Impotence and Infertility. Williams & Wilkins, Baltimore 1988, pp. 70–83.

    Google Scholar 

  2. Nogeira, M. C., Herbaut, A. G., Wespes, E.: Neurophysiological investigations of two hundred men with erectile dysfunction. Interest of bulbocavernous reflex and pudendal evoked potentials.Eur. Urol., 18 (1), 37 (1990).

    Google Scholar 

  3. Kraner, R. J., Siroky, M.: Study on sacral evoked potentials,J. Urol., 124, 872 (1980).

    Google Scholar 

  4. Opsomer, R. J., Guerit, J. M., Wese, F. X., Van Cangh, P. J.: Pudendal cortical somatosensory evoked potentials.J. Urol., 135, 1216 (1986).

    PubMed  CAS  Google Scholar 

  5. Opsomer, R. J., Boccasena, P., Pesce, F., Rossini, P. M.: Sympathetic skin responses (SSRs) following peripheral nerve stimulation.Int. J. Impotence Res., 4 (Suppl. 2), A19 (1992).

    Google Scholar 

  6. Ertekin, C., Reel, F.: Bulbocavernous reflex in normal men and in patients with neurogenic bladder and/or impotence.J. Neurol. Science, 28, 1 (1976).

    Article  CAS  Google Scholar 

  7. Siroky, M. B., Sax, D. S., Krane, R. J.: Sacral signal tracing: The electrophysiology of the bulbocavernous reflex.J. Urol., 122, 661 (1979).

    PubMed  CAS  Google Scholar 

  8. Bemelmans, B. L. H., Meuleman, E. J. H., Anten, B. W. M., Doesburg, W. H., Van Kerrebroek, P. E., Debruyne, F. M.: Penile disorders in erectile dysfunction:, Results of a comprehensive neuro-urophysiological diagnostic evaluation in 123 patients.J. Urol., 146, 777 (1991).

    PubMed  CAS  Google Scholar 

  9. Padma-Nathan, H., Levine, F.: Vibratory testing of the penis.J. Urol., 137, 201 (1987).

    Google Scholar 

  10. Padma-Nathan, H.: Neurologic evaluation of erectile dysfunction.Urol. Clin. North. Am., 15 (1), 77 (1988).

    PubMed  CAS  Google Scholar 

  11. Lue, T. F.: Neuroanatomy of penile erection: Its relevance to iatrogenic impotence.J. Urol., 131, 273 (1984).

    PubMed  CAS  Google Scholar 

  12. Lue, T. F.: Male sexual dysfunction. In: Smith's General Urology, 12th ed. Ch. 37. Prentice Hall Inc. 1988, pp. 663–675.

  13. Linden, D., Daffertshofer, M., Berlit, P.: Neurophysiological evaluation of the autonomic nervous system in erectile dysfunction.Int. J. Impotence Res., 4 (Suppl. 2), A20 (1992).

    Google Scholar 

  14. Shahani, B. T., Day, T. J., Cros, D., Nofal Kalil, Kneebone, C. S.: R-R-internal variations and sympathetic skin response in the assessment of autonomic functions in peripheral neurography.Arch. Neurol., 47, 659 (1988).

    Google Scholar 

  15. Wagner, G., Gerstemberg, T.: Human in vivo studies of electrical activity of corpus cavernosum.J. Urol., 139, 327 (1988).

    Google Scholar 

  16. Wagner, G., Gerstemberg, T., Levin, R. J.: Electrical activity of corpus cavernosum during flaccidity and erection of the human penis.J. Urol., 142, 723 (1989).

    PubMed  CAS  Google Scholar 

  17. Stief, C., Djamilian, M., Schaebsdau, F., Truss, M. C., Schlick, R. W., Abicht, J. H., Allhott, E. P., Jonas, U.: Single potential analysis of cavernous electric activity—A possible diagnosis of autonomic impotence?World J. Urol., 8, 75 (1990).

    Article  Google Scholar 

  18. Stief, C., Djamilian, M., Anton, P., De Riese, W., Allhott, E. P., Jonas, U.: Single potential analysis of cavernous electrical activity in impotent patients: A possible diagnostic method for autonomic cavernous dysfunction and cavernous muscle degeneration.J. Urol., 146, 771 (1991).

    PubMed  CAS  Google Scholar 

  19. Stief, C., Merckx, L.: Single potential analysis of cavernous electrical activity (SPACE)-Experience and refinements.Int. J. Impotence Res., 4, 131 (1992).

    Google Scholar 

  20. Stief, C. G., Thon, W. F., Djamilian, M.: Transcutaneous registration of cavernous smooth muscle electrical activity: Non invasive diagnosis of neurogenic autonomic impotence.J. Urol., 147, 47 (1992).

    PubMed  CAS  Google Scholar 

  21. Sasso, F., Gulino, G., Menchinelli, P., Alcini, E.: La registrazione dell'attività elettrica dei corpi cavernosi. Valore clinico e limiti. In: Proceedings of 8th Meeting of the Italian Society of Andrology, pp. 293–296. Acta Medica Edizioni e Congressi. Ischia, June 1993.

  22. Sasso, F., Gulino, G., Alcini, A., Di Pinto, A., Alcini, E.: La elettromiografia dei corpi cavernosi (CC-EMG): Esperienze preliminari nella diagnostica del paziente impotente. Proceedings of the 67th Congress of the Italian Society of Urology, Milano, 1994.

  23. Sasso, F., Gulino, G., Alcini, E.: Corpora cavernosa electromyography (CC-EMG) in impotent patients after radical cystectomy: Preliminary results.Int. J. Impotence Res., 6 (Suppl. 1), D211 (1994).

    Google Scholar 

  24. Sasso, F., Gulino, G., Alcini, A., Di Pinto, A., Alcini, E., Crucitti, F.: La elettromiografia dei corpi cavernosi (CC-EMG) nell'impotenza dopo cisto-prostatectomia radicale. Proceedings of the 96th Congress of the Italian Society of Surgery. Minerva Medica, Rome, 1994, pp. 1637–1639.

    Google Scholar 

  25. Gerstemberg, T., Nordling, J., Hald, H., Wagner, G.: Standardized evaluation of erectile dysfunction in 15 consecutive patients.J. Urol., 141, 857 (1989).

    Google Scholar 

  26. Gerstemberg, T., Nordling, J.: Corpus cavernosum electromyography measured by needle and surface electrodes.Int. J. Impotence Res., 4 (Suppl. 2), A21 (1992).

    Google Scholar 

  27. Portner, M. R.: Cavernous EMG monitoring during drug-induced penile erection. In: Cavernous Smooth Muscle Electromyography. Published by WIEST Inc. 1992, pp. 64–78.

  28. Uhlemann, H.: The use of transcutaneous registration of cavernous electrical activity in the diagnosis of the cavernous autonomic innervation with SPACE. In: Cavernous Smooth Muscle Electromyography. Published by WIEST Inc. 1992, pp. 43–49.

  29. Couturier, D., Gastric electromyography. Clinical investigation of gastric function.Gastrointest. Res., 17, 297 (1990).

    Google Scholar 

  30. Kondo, T., Tamura, K., Onoe, K., Takahira, H., Ohta, Y., Yamabavashi, H.: In vivo recording of electrical activity of canine tracheal smooth muscle.Am. J. Physiol., 72 (1), 135 (1992).

    CAS  Google Scholar 

  31. Stief, C., Hoppner, C., Jonas, U., Mandrek, K., Noak, T., Golenhofen, K.: Electrical and mechanical activity of isolated strips from rabbit penile corpus cavernosum.Int. J. Impotence Res., 4 (Suppl. 2), A36 (1992).

    Google Scholar 

  32. Junemann, K. P., Buhrle, C. P., Stief, C. G.: Current trends in corpus cavernosum EMG. Conclusion of the First International Workshop on Smooth muscle EMG recordings/Leiomyogram.Int. J. Impotence Res., 5 (2), 105 (1993).

    CAS  Google Scholar 

  33. Buhrle, C. P., Junemann, K. P., Berle, B.: MYDAS, a data acquisition and analysis program for automatic processing of electromyographic data.Int. J. Impotence Res., 4 (Suppl. 2), A28 (1992).

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Catholic University of the Sacred Heart, Rome, Italy

    F. Sasso, G. Gulino & E. Alcini

Authors
  1. F. Sasso
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Gulino
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. Alcini
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sasso, F., Gulino, G. & Alcini, E. Corpus cavernosum electromyography (CC-EMG): A new technique in the diagnostic work-up of impotence. International Urology and Nephrology 28, 805–818 (1996). https://doi.org/10.1007/BF02550732

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02550732

Keywords

Search

Navigation