title: Clinical elicitation of the penilo-cavernosus reflex in circumcised men.
abstract: OBJECTIVE
  • To test clinical observations that the penilo-cavernosus reflex is much more difficult to elicit in circumcised men.
  
  
  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.
  
  
  CONCLUSIONS
  • 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: Institute of Clinical Neurophysiology, Division of Neurology, University Medical Centre, Ljubljana, Slovenia. simon.podnar@kclj.si
authors: Simon
authors: S
authors: Podnar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002944:Circumcision, Male; D004558:Electric Stimulation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000294:innervation / Q000502:physiology*; D010812:Physical Stimulation / Q000379:methods; D011446:Prospective Studies; D012018:Reflex / Q000502:physiology*