After Spinal Cord Injury Sexual Functions and Histological-Physiological Changes in the Penis

The control of sexual function is made by central nervous system like many body functions. Normal hypothalamicpituitary-gonadal axis are needed for erection health. Autonomic and somatic nervous system are in charge of the erection except the central nervous system. These nerves are responsible in achieving erection by stimulation of the bulbocavernosus and iskiocavernosus muscle [1]. Somatic nervous structures (S2-4) with Onuf nucleus provide the sensation of the penis with these muscles. Nitric oxide (NO) synthesis occurs due to parasympathetic innervations comes from preganglionic neurons in the intermediolateral columna in this level. Nitric oxide provides erection with cyclic guanosine monophosphate (cGMP). Erectile dysfunction may growth in the process of the beginning of these pathways or shortage [2]. There are 3 types of erection; Psychogenic, nocturnal and reflexes erection. While psychogenic erections happening with various alerts, the mechanism of nocturnal erection is not illuminated accurately. The reflex erection realize with touch and requires the normal functioning of parasympathetic structures and intermediolateral in the sacral cord. Sympathetic structures of the spinal cord (T10-L2) are involved in the psychogenic erection. The presence of bulbocavernosal reflex also indicate the presence of the sacral reflex [3].