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Effects of transanal pelvic plexus stimulation on penile erection: clinical implications

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Abstract

Objective

To determine the ability of transanal pelvic plexus stimulation (TPPS) in inducing penile tumescence in patients with non-neurogenic erectile dysfunction (ED) and to compare the erection degree with papaverine-induced erection.

Patients and methods

The cavernous electrical activity (CEA) in 21 men with non-neurogenic erectile dysfunction was measured during TPPS by electromyography of corpus cavernosum and the erection degree of penis (flaccid, semi-rigid, rigid) was noted. The stimulation amplitude was increased from 20 to 100 mA. All patients also underwent intracavernous papaverine injection and further CEA recordings were obtained.

Results

Twelve and nine patients were diagnosed with vasculogenic (VED) and non-vasculogenic ED (NVED), respectively. TPSS led to a penile erectile response in 12 patients (57%), whereas papaverine injection caused erection in 16 (76.2%) patients. The mean baseline CEA (16.9 ± 9.1 mV) did not change with TPPS, but papaverine significantly decreased the mean CEA to 12.3 ± 4.9 mV (P < 0.001). CEA recordings of 16 (76.2%) patients revealed a significant decrease after papaverine injection, however seven (33.3%) patients showed significant CEA decrease in response to TPPS. Both TPPS and papaverine were observed to have a higher effect in patients with NVED in terms of inducing penile erection and decreasing CEA compared to their effects in patients with VED.

Conclusion

TPPS induces penile erection and decreases CEA for some extent, but to a lesser degree compared to papaverine. As further improvements are achieved in the methodology of TPPS, it may be a valuable method in the evaluation patients with erectile dysfunction.

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Authors and Affiliations

  1. II. Urology Clinic, Ankara Atatürk Teaching and Research Hospital, Ankara, Turkey

    Onder Kayigil, Koray Agras, Mesut Gurdal, Ege Can Serefoglu, Emrah Okulu & Yusuf Ucgul

  2. Angora Evleri, Sahin Sokak, E-4 blok No:11, Ankara, 06800, Turkey

    Koray Agras

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  1. Onder Kayigil
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  2. Koray Agras
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  3. Mesut Gurdal
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  4. Ege Can Serefoglu
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  5. Emrah Okulu
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  6. Yusuf Ucgul
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Correspondence to Koray Agras.

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Kayigil, O., Agras, K., Gurdal, M. et al. Effects of transanal pelvic plexus stimulation on penile erection: clinical implications. Int Urol Nephrol 39, 1195–1201 (2007). https://doi.org/10.1007/s11255-007-9205-y

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  • DOI: https://doi.org/10.1007/s11255-007-9205-y

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