MODERN APPROACHES OF ERECTILE DYSFUNCTION DIAGNOSIS

Aim. Assessment of functional status of muscles of pelvic floor and conductive ability of corticospinal tract in healthy men and patients with erectile dysfunction (ED) with compiling the database of electromyography parameters.
Methods. 52 patients with ED (age 23-67 years) and 12 healthy volunteers, serve as controls, were included into the study. Acicular electromyography of muscles of pelvic floor and magnetic stimulation of cortical and spinal centers with registration of induced motor response were performed.
Results. In healthy volunteers referent database of electromyography parameters was developed - latence of cortical and segmental period of motor response, period of central motor conduction, amplitude of action potential. Patients with ED were characterized with disturbances of conduction in corticospinal tract - increase of latency of period of cortical and segmental motor response >10%, prolongation of period of central motor conduction >15%, and decrease of motor unit potential amplitude. Among electromyography parameters spontaneous activity of muscle fibers and poliphasy of motor unit potential demonstrated ongoing process of denervation. In 80% patients with ED and chronic pelvic pain signs of ongoing denervation-renervation process were revealed. In patients with ED and inflammatory diseases of lower urinary tract signs of denervation- renervation are rare and, if present, are minimal.
Conclusion. Denervation processes in pelvic floor muscles should be considered in clinical assessment of patients with ED.

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