title: H-reflex and physiologic measures of ejaculation in men with spinal cord injury.
abstract: OBJECTIVE
  To investigate the various physiologic parameters characterizing and predicting ejaculation.
  
  
  METHODS
  Single case-control study.
  
  
  METHODS
  A referred care center and university setting.
  
  
  METHODS
  Two men with spinal cord injury (SCI) and 2 control subjects.
  
  
  METHODS
  Subjects were asked to self-stimulate with a Ferticare vibrator to induce ejaculation over 5 to 8 independent sessions.
  
  
  METHODS
  Penile tumescence, blood pressure, heart rate, electromyographic activity of the bulbocavernosus muscles, abdominal muscles, soleus H-reflex, and occurrence of ejaculation.
  
  
  RESULTS
  Changes on all measures were observed, with penile tumescence being more stable in control subjects. Blood pressure increased in both groups, whereas tachycardia was observed in controls and bradycardia in subjects with SCI. H-reflex dropped slightly in controls but increased in subjects with SCI. Muscular patterns differed on ejaculatory success or failure.
  
  
  CONCLUSIONS
  Physiologic changes on all measures can be observed in men with SCI as a function of ejaculation. Changes include hypertension and bradycardia, characteristic of hyperreflexia, and tachycardia in controls. The neural mechanisms underlying these patterns are discussed. H-reflex showed increased spinal cord excitability in subjects with SCI after ejaculation, which suggests spasticity. The results support investigation of the H-reflex to predict ejaculatory success or failure in men with SCI, along with specific analysis of muscular patterns.
authors.affiliation: Department of Sexology, Université du Québec à Montréal, CP 8888, Succursale Centre Ville, Montréal, Québec H3C 3P8, Canada. courtois.frederique@uqam.ca
authors.forename: Frédérique
authors.initials: F
authors.lastname: Courtois
authors.forename: Robert
authors.initials: R
authors.lastname: Geoffrion
authors.forename: Eric
authors.initials: E
authors.lastname: Landry
authors.forename: Marc
authors.initials: M
authors.lastname: Bélanger
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D001919:Bradycardia / Q000503:physiopathology; D016022:Case-Control Studies; D004542:Ejaculation / Q000502:physiology*; D004576:Electromyography; D006181:H-Reflex / Q000502:physiology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000502:physiology; D010410:Penile Erection / Q000502:physiology; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D013997:Time Factors