Posttraumatic erectile potential of spinal cord injured men: How physiologic recordings supplement subjective reports

Objective: To investigate by means of a neurophysiologic model the remaining erectile function in spinal cord injured men. Design: A nonrandomized control trial. Setting: A Referred Care Center. Subjects: Forty-seven spinal cord injured men and 7 noninjured controls. Intervention: The subject penile responses were recorded by a penile strain gauge during two sessions-one to obtain baseline responses, and one with reflexogenic stimulation (masturbation) and psychogenic stimulation (film). Measures: Average tumescence, maximal tumescence, percentage rigidity, and duration of tumescence and rigidity. Results: Significant results were found for subjects with lower lesions using psychogenic stimulation as their optimal mode compared with reflexogenic stimulation as an alternate mode, and for subjects with higher lesions using reflexogenic stimulation as their optimal mode, compared with psychogenic stimulation as an alternate mode. The responses with optimal stimulation modes were comparable to those achieved by controls. Conclusion: The findings validate the neurophysiologic model of posttraumatic erectile potential as a function of the lesion type and stimulation source. The results were comparable to those of noninjured subjects; the potential for normal function is present and may be amenable to sexual rehabilitation or use in conjunction with new oral drug treatments for impotence. (C) 1999 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.