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Physiologic studies of male sexual dysfunction in multiple sclerosis
C C Yang1, J D Bowen, G H Kraft
1Department of Urology, University of Washington, Seattle 98195-6510, USA.
Multiple Sclerosis (Houndmills, Basingstoke, England)
|September 11, 2001
Summary
Genital somatosensory evoked potential (SEP) abnormalities are common in men with multiple sclerosis (MS) and sexual dysfunction. Unilateral testing of the dorsal nerves of the penis (DNP) is more sensitive for detecting these disruptions.
Area of Science:
- Neuroscience
- Urology
- Neurology
Background:
- Sexual dysfunction is a common complication in men with multiple sclerosis (MS).
- The precise neural mechanisms underlying sexual dysfunction in MS remain incompletely understood.
- Genital sensory pathways are implicated but require detailed investigation.
Purpose of the Study:
- To define neural disruptions causing sexual dysfunction in men with MS.
- To utilize genital electrodiagnostic testing and nocturnal penile tumescence and rigidity monitoring.
- To compare standard pudendal somatosensory evoked potential (SEP) testing with a modified unilateral dorsal nerve of the penis (DNP) SEP test.
Main Methods:
- Recruited 13 men with MS and sexual dysfunction and 12 healthy male controls.
- Performed standard pudendal SEP testing and a modified unilateral DNP SEP test.
- Assessed nocturnal erectile function in MS subjects using RigiScan testing.
Main Results:
- DNP SEP abnormalities were found in all but one MS subject.
- Unilateral DNP SEP testing identified abnormalities missed by standard bilateral testing.
- Seven MS subjects with abnormal SEP latencies had normal nocturnal erectile activity.
Conclusions:
- Genital SEP abnormalities are prevalent in men with MS experiencing sexual dysfunction.
- Unilateral DNP SEP testing demonstrates higher sensitivity than standard pudendal SEP testing.
- Disruption of genital somatosensory pathways may cause sexual dysfunction in MS, potentially with intact efferent tracts.