ELECTROPHYSIOLOGICAL DIAGNOSTICS IN ERECT ILE DYSFUNCTION

So far, electrophysiological examinations have rarely been used in the diagnosis of erectile dysfunction (ED) mainly because the methods ava ilable only allow somatic neuron pathways to be examined whose relevan ce for the mainly autonomically controlled erection is evaluated diffe rently. At present, impaired penile nerve supply as the possible cause of ED can only be evaluated through neurophysiological screening of t he somatic and autonomic pathways of the pelvic floor, and not just by one simple method. Diagnosing ED should include testing of motoric ef ferences through electroneurography of the pudendal nerve and electrom yography of the external anal sphincter and the urethral sphincter. Se nsitive afference is tested with somatosensory evoked potentials of th e pudendal nerve. New methods that are available for the examination o f autonomic pathways are the penile sympathetic skin response and the EMG of the corpus cavernosum Together with the other electrophysiologi cal examinations, they allow neurogenic causes to be determined and di fferentiate not only between central and peripheric lesions, but also between acute and chronic changes. Prognosis can also be estimated. A crucial diagnostic deficit is the fact that it is still not possible t o test the parasympathetic system directly.