Document Detail

Sphincteric events during penile vibratory ejaculation and electroejaculation in men with spinal cord injuries.
MedLine Citation:
PMID:  11176389     Owner:  NLM     Status:  MEDLINE    
PURPOSE: We investigate internal and external sphincter responses during penile vibratory stimulation and electroejaculation in men with spinal cord injury. MATERIALS AND METHODS: Ejaculation induction with simultaneous recording of external and internal sphincter pressures was performed in 9 spinal cord injured men. Of the patients with upper motor neuron lesions 3 underwent penile vibratory stimulation and 3 underwent electroejaculation. In 3 men who did not respond to PVS, including 1 with upper motor neuron and 2 with lower motor neuron lesions, penile vibratory stimulation and subsequent electroejaculation were performed. RESULTS: In successful penile vibratory stimulation and electroejaculation upper motor neuron cases external sphincter pressure first reached a peak (average 180 cm. H2O) and subsequently decrease followed in 3 to 10 seconds by a peak in internal sphincter pressure (average 178 cm. H2O), which exceeded external sphincter pressure and ejaculation occurred. During electroejaculation, the pattern progressed, despite complete discontinuation of electrical stimulation. In electroejaculation, there was a trend for a more rapid return of external sphincter pressure greater than internal sphincter pressure, which may explain the electroejaculation retrograde fraction. In nonresponders external sphincter pressure never increased to more than 105 cm. H2O in response to penile vibratory stimulation and no ejaculation was induced. In nonresponders to penile vibratory stimulation, electroejaculation induced a typical sustained increase in internal sphincter pressure and external sphincter pressure but at lower peak pressures. CONCLUSIONS: Forceful contraction of the external sphincter followed by contraction of the internal sphincter always precedes ejaculation during electroejaculation and penile vibratory stimulation. Similarities between penile vibratory stimulation and electroejaculation suggest that the latter induces ejaculation via a complex neurological pathway rather than by simple direct end organ stimulation. The sustained nature of the response to electroejaculation suggests that electrical stimulation should be stopped completely during ejaculation to allow more relaxation of the external sphincter, as this may lead to a decrease in the retrograde fraction.
J Sønksen; D A Ohl; G Wedemeyer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of urology     Volume:  165     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-02-22     Completed Date:  2001-05-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  426-9     Citation Subset:  AIM; IM    
Section of Urology, University of Michigan, Ann Arbor, Michigan, USA.
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MeSH Terms
Electric Stimulation*
Spinal Cord Injuries / physiopathology*
Time Factors
Urethra / physiopathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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