Neurogenic Sexual Dysfunction Treatment: A Systematic Review.

Area of Science:

• Neuroscience
• Urology
• Sexual Medicine

Background:

• Neurogenic sexual dysfunction (NSD) originates from central, peripheral, or combined nervous system disorders.
• Accurate diagnosis of NSD level is crucial for selecting optimal patient treatment and reducing sexual complaints.

Purpose of the Study:

• To review the management strategies for neurogenic sexual dysfunction (NSD) stemming from central nervous system disorders and peripheral neuropathy.

Main Methods:

• A systematic review of English-language literature up to July 2019 was conducted.
• Search terms included "neurogenic sexual dysfunction" OR "neurogenic erectile dysfunction" AND "treatment" OR "management".
• Data were extracted and analyzed using the PICOS framework (participants, interventions, comparators, outcomes, study design).

Main Results:

• Phosphodiesterase type 5 inhibitors (sildenafil, tadalafil, vardenafil) are effective first-line treatments for neurogenic erectile dysfunction.
• Second-line options include intracavernous injections and vacuum systems, particularly for spinal cord injury patients.
• Penile prosthesis implantation is a third-line surgical option with potential benefits for bladder management, despite higher infection risks.

Conclusions:

• Current management for male NSD involves a tiered approach: oral medications, injections/vacuum devices, and surgical implants.
• More research is essential to develop effective therapies for female sexual dysfunction related to neurological conditions.
• Further prospective studies are needed to optimize treatment for sexual function and quality of life in patients with NSD.