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Erectile impotence in multiple sclerosis: a neurophysiological study

A Ghezzi1, G M Malvestiti, S Baldini

  • 1Centro Studi Sclerosi Multipla, Ospedale di Gallarate, Università di Milano, Italy.

Journal of Neurology
|February 1, 1995
PubMed
Summary
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Neurophysiological tests for erectile dysfunction in multiple sclerosis (MS) patients showed abnormalities but lacked diagnostic value. Nocturnal penile tumescence testing often yielded normal results, even in severe cases.

Area of Science:

  • Neuroscience
  • Urology
  • Neurology

Background:

  • Erectile dysfunction (ED) is a common complication in multiple sclerosis (MS).
  • The diagnostic utility of specific neurophysiological tests for ED in MS patients is not well-established.

Purpose of the Study:

  • To evaluate the diagnostic usefulness of pudendal evoked potentials, magnetic stimulation of the bulbocavernosus muscle, and the bulbocavernosus reflex in MS patients with impotence.
  • To assess nocturnal penile tumescence (NPT) in MS patients with ED.

Main Methods:

  • Pudendal evoked potentials, motor evoked potentials of the bulbocavernosus muscle via magnetic stimulation, and bulbocavernosus reflex were recorded in 34 MS patients.
  • Nocturnal penile tumescence was assessed in 14 of these patients.

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Main Results:

  • Abnormalities in neurophysiological responses were observed in a significant number of patients (26/34 for evoked potentials, 20/34 for motor evoked potentials, 3/34 for reflex).
  • No correlation was found between these neurophysiological abnormalities and the presence or severity of erectile dysfunction.
  • Nocturnal penile tumescence was normal in 10 out of 14 patients, including three with severe paraplegia.

Conclusions:

  • Current neurophysiological tests have limited diagnostic value for evaluating erectile dysfunction in multiple sclerosis patients.
  • Nocturnal penile tumescence may remain normal in MS patients with ED, suggesting other contributing factors beyond peripheral nerve dysfunction.