Multiple Sclerosis, August
2001, vol. 7, no. 4, pp. 249-254(5)
Objective:
We conducted this investigation to
better define the neural disruptions that result in sexual dysfunction
in men with multiple sclerosis (MS), using genital electrodiagnostic testing
and nocturnal penile tumescence and rigidity monitoring.
Methods:
Thirteen men with MS and sexual dysfunction
were recruited for the study. Twelve healthy, sexually potent men were
enrolled as controls. All underwent pudendal somatosensory evoked potential
(SEP) testing using standard methods, and a new modification to isolate
the right and left dorsal nerves of the penis. RigiScan testing was performed
on the MS subjects to assess nocturnal erectile function.
Results:
Unilateral and bilateral DNP SEPs
were able to be performed on the control subjects. In all but one MS subjects,
DNP SEP abnormalities were found. Three men had normal latency bilateral
DNP SEP latencies, but on unilateral DNP testing, abnormalities were identified.
Seven men, including those with abnormal or absent SEP latencies, had normal
nocturnal erectile activity. There was no correlation between overall functional
status, presence of abnormal or absent SEP, and quality of nocturnal erectile
activity.
Conclusions:
Genital SEP abnormalities are common
in men with MS and sexual dysfunction. Unilateral DNP SEP testing was more
sensitive in identifying abnormalities than the standard method of pudendal
SEP testing. One of the causes of sexual dysfunction in men with MS may
be due to genital somatosensory pathway disruption, with sparing of the
efferent tracts in some men.
Yang C.C. [2] *; Bowen J.D. [3];
Kraft G.H. [3]; Uchio E.M. [1]; Kromm B.G. [1]
[1] Department of Urology, University
of Washington, Seattle, Washington, WA, USA [2] Department of Neurology,
University of Washington, Seattle, Washington, WA, USA [3] Department of
Physical Medicine and Rehabilitation, University of Washington, Seattle,
Washington, WA, USA [*] Correspondence: C Yang, Department of Urology,
Box 356510, Room BB1115, University of Washington, Seattle, WA 98195-6510,
USA
Abstract: