J Neurol Sci 2001 Jun 15;187(1-2):1-5
Zorzon M, Zivadinov R, Monti Bragadin
L, Moretti R, De Masi R, Nasuelli D, Cazzato G
Department of Neurology, Cattinara
Hospital, Strada di Fiume, 447-34149, Trieste, Italy
Background and objective.
Sexual dysfunction severely affects
the quality of life of patients, but longitudinal studies of sexual function
in multiple sclerosis are lacking. We performed a study on a group of patients
with multiple sclerosis to evaluate the change in sexual function and to
examine the relationship between sexual dysfunction and other clinical
variables over time.
Methods.
A 2-year follow-up study on 99 patients
with definite multiple sclerosis. Information on sexual and sphincteric
disturbances have been collected through face-to-face structured interviews.
Disability, independence, cognitive performances and psychological functioning
have also been assessed. Spearman rank correlation analysis corrected for
multiple comparisons, and linear regression analysis have been performed
to test variables relationship and remove the effect of potential confounding
covariates.
Results.
The proportion of patients with sexual
dysfunction remained over 70% and did not change during the 2-year follow-up,
but the extent and number of symptoms increased significantly The number
of symptoms of sexual dysfunction did not change significantly after an
exacerbation. Significantly, more patients than before the study resorted
to counseling and discussed with doctors of sexual matters. In the univariate
analysis, changes in sexual function over time correlated with changes
in bladder function (r=0.47, p<0.0001) and EDSS score (r=0.41, p<0.0001),
but the multivariate analysis demonstrated that only bladder dysfunction
was independently related to sexual dysfunction (R=0.36, p=0.003) when
the effect of psychological factors were removed.
Conclusions.
Symptoms of sexual dysfunction increase
in significance and number over time in patients with multiple sclerosis.
Relapses did not influence the number of symptoms of sexual dysfunction,
but a worsening of pre-existing symptoms cannot be excluded. The change
of sexual function appears to be independently associated to bladder dysfunction.
PMID: 11440738, UI: 21334439