The cause of constipation (coprostasis) in most cases are gastroenterological or other somatic diseases. “Sheep” (fragmented) feces and / or stool retention should always cause suspicion of a volumetric process in the colon or rectum.
Stool incontinence is usually accompanied by urinary incontinence, impaired sphincter tone and / or anal reflex, and / or sensitivity disorders in the innervation zone of the sacral roots. The reason is a bilateral violation of afferent bonds with segments S1 – S4.
Hypersensitivity in the rectum without the symptoms mentioned above often develops and is accompanied by imperative urges to defecate. Sometimes it is based on a tumor of the rectum or an inflammatory disease of the colon, but in most cases it is not possible to determine the cause.
In general, the control over the male and female sexual function is carried out by the same structures of the central and peripheral nervous system, since the principles of their structure are the same. Their organic disorders have a more significant effect on the male body, so a violation of male potency often has to be diagnosed and corrected by a neurologist. The etiological differential diagnosis of such disorders will be summarized here.
The term ” potency ” refers to the ability of the male penis to erection, which is a prerequisite for its introduction into the vagina. Structures that provide normal male potency include:
• The centers whose irritation causes an erection are located in the hypothalamus, possibly in the preoptic and inter-septal zones, as well as in the limbic system (amygdala?). Here, on the one hand, there are “endocrine impulses” (for libido to occur, a certain concentration of sex hormones in the blood is necessary), and on the other hand, psychic influences.
• Impulses from the hypothalamic centers pass from two sides in the composition of the fibers located in the anterolateral quadrants of the spinal cord to the reflex centers of erection and ejaculation.
• In the sacral segments S2 — S4 there is a parasympathetic center of erection: – it contains, on the one hand, somatic afferent fibers coming from the skin in the genital area and perineum (as part of the perineal, scrotal nerves and dorsal nerve of the penis related to the system cramped nerves [S2 — S3]), on the other hand, visceral afferent fibers, for example from the bladder; – efferent impulses emanating from the center , which travel along parasympathetic fibers in the roots of S2-S4 roots, enter the pelvic nerve and erectile nerves. After switching, mainly in the plexus of the prostate, they pass as part of the postganglionic fibers to the prostate, but primarily to the vessels of the cavernous bodies; – The sacral center of an erection is influenced by hypothalamic centers.
• Efferent (somatomotor) fibers from the sacral segments S2 — S4 reach the urethral sphincter muscle as well as the striated muscle, the bulbocavernous and sciatic cavernous, as part of the sacral nerve.
• Sympathetic innervation of the genital organs : – originates, possibly in one of the centers at the pectoral-lumbar level; – passes in the form of efferent fibers from Th12 – L2 to the lumbar region of the borderline trunk;
– from there, as part of the internal nerves, it passes to the pancreas plexus and then to the inferior mesenteric ganglion;
– after switching, the sympathetic postgan-glionar fibers pass as part of the pelvic plexus or pancreas nerves and innervate the smooth muscles of the seminal vesicles, vas deferens and ejaculatory ducts, and the prostate gland.
• The cavernous bodies of the penis are usually not full of blood. Arterial blood supply through the internal genital arteries does not occur through the caveous arteries of the penis, since their ducts are narrowed by muscle thickening, but through the anastomotic arteries to the system of superficial veins. During an erection, on the contrary, muscle thickenings relax (under the influence of parasympathetic impulses), blood fills the venous cavities of the cavernous body and, under the influence of contraction of the muscle fibers of the venous walls, as well as the mechanical effect of the connective tissue membranes, is retained in them.