Simon Podnar1. 1. Institute of Clinical Neurophysiology, Division of Neurology, University Medical Centre, Ljubljana, Slovenia. simon.podnar@kclj.si
Abstract
OBJECTIVE: • To test clinical observations that the penilo-cavernosus reflex is much more difficult to elicit in circumcised men. PATIENTS AND METHODS: • Men consecutively referred for uro-neurological or uro-neurophysiological examination were prospectively included. • Those with possible sacral neuropathic lesions were excluded. • A history was obtained, and a clinical neurological examination was performed. • The penilo-cavernosus reflex was tested clinically and neurophysiologically using electrical and mechanical stimulation. • Reflex elicitability scores in groups of circumcised men, men with foreskin retraction and a control group of uncircumcised men were compared using the Mann-Whitney U test. RESULTS: • The reflex was clinically non-elicitable in 73%, 64% and 8% of 30 circumcised men, 15 men with foreskin retraction, and 29 control men, respectively. • The scored reflex elicitability was significantly (P < 0.001) higher in control men than in the other two groups clinically, but not neurophysiologically. CONCLUSION: • The study confirmed the lower clinical and similar neurophysiological elicitability of the penilo-cavernosus reflex in circumcised men and in men with foreskin retraction. This finding needs to be taken into account by urologists and other clinicians in daily clinical practice.
OBJECTIVE: • To test clinical observations that the penilo-cavernosus reflex is much more difficult to elicit in circumcised men. PATIENTS AND METHODS: • Men consecutively referred for uro-neurological or uro-neurophysiological examination were prospectively included. • Those with possible sacral neuropathic lesions were excluded. • A history was obtained, and a clinical neurological examination was performed. • The penilo-cavernosus reflex was tested clinically and neurophysiologically using electrical and mechanical stimulation. • Reflex elicitability scores in groups of circumcised men, men with foreskin retraction and a control group of uncircumcised men were compared using the Mann-Whitney U test. RESULTS: • The reflex was clinically non-elicitable in 73%, 64% and 8% of 30 circumcised men, 15 men with foreskin retraction, and 29 control men, respectively. • The scored reflex elicitability was significantly (P < 0.001) higher in control men than in the other two groups clinically, but not neurophysiologically. CONCLUSION: • The study confirmed the lower clinical and similar neurophysiological elicitability of the penilo-cavernosus reflex in circumcised men and in men with foreskin retraction. This finding needs to be taken into account by urologists and other clinicians in daily clinical practice.
Authors: Brian J Morris; Richard G Wamai; Esther B Henebeng; Aaron Ar Tobian; Jeffrey D Klausner; Joya Banerjee; Catherine A Hankins Journal: Popul Health Metr Date: 2016-03-01