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Commande nerveuse peripherique de l’erection

Peripheral nervous control of penile erection

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Abstract

Local mechanisms causing penile erection and detumescence result from variation in tone of vascular and trabecular smooth muscles and in a lesser part of striated muscles around the crura penis. All these events are neurally mediated. We reviewed human and animal data concerning the functional peripheral neuroanatorny of erection. General organization of peripheral nervous system is recalled. Somatic efferents of the pudendal nerve, originating in the sacral spinal cord, innervate the striated musculature of the perineum. Somatic afferents of the penis are conveyed by the dorsal penile nerve, a branch of the pudendal nerve. Afferent terminations project into the spinal cord, their role is discussed. Parasympathetic pathways are involved in the reflexogenic erections. Sympathetic pathways destinated to the erectile structures are more complex. They are issued from thoracolumbar spinal cord and travel through the hypogastric nerve or the lumbosacral sympathetic chain. Sympathetic fibers originating in the sacral sympathetic chain are present in both pelvic and pudendal nerves. Inhibitory role on the erection of the sympathetic nervous system is well-known, it could be also responsible for psychogenic erections. Parasympathetic and sympathetic fibees are mixed in the pelvic plexus and the cavernous nerves which are described. Relations between the four sets of peripheral nerves (somatic efferents, penile afferents, thoracolumbar sympathetic sacral parasympathetic and sympathetic) are discussed.

Resume

Les mécanismes locaux responsables de l’érection dépendent de l’activité musculaire lisse caverneuse et vasculaire et pour une moindre part des muscles striés ischiocaverneux. Le système nerveux autonome et somatique commande l’érection en contrôlant respectivement le tonus musculaire lisse et strié. Le nerf honteux contient des fibres somatiques efférentes et les afférences sensitives issues du pénis via le nerf dorsal du pénis L’innervation parasympathique issue de la moëlle sacrée, emprunte les nerfs pelviens puis caverneux. L’organisation du système nerveux sympathique impliqué dans l’érection est plus complexe. Les fibres nerveuses sympathiques gagnent les structures érectiles par les nerfs hypogastriques ou la chaine sympathique lombosacrée qu’elles quittent pour rejoindre les nerfs honteux ou pelvien. Le rôle de ces différents contingents nerveux est discuté à la lumière des données cliniques et de l’expérimentation animale.

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Correspondence to F. Giuliano.

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Giuliano, F., Rampin, O., Benoît, G. et al. Commande nerveuse peripherique de l’erection. Androl. 2, 123–127 (1992) doi:10.1007/BF03034689

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Key words

  • neuroanatomy
  • neurophysiology
  • autonomic nervous system
  • penile erection

Mots clefs

  • neuroanatomie
  • neurophysiologie
  • système nerveux autonome
  • érection