PREVALENCE OF ERECTILE DYSFUNCTION POST-STROKE, AND ASSOCIATED RISK FACTORS AND CO-MORBIDITIES

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Article Title:	PREVALENCE OF ERECTILE DYSFUNCTION POST-STROKE, AND ASSOCIATED RISK FACTORS AND CO-MORBIDITIES
Authors:	Hreniuc N. Catalin¹, Dugacicu Nicolae¹, Marti Teodora², Ioiart Ioan³
Affiliation:	¹Department of Neurology, Western University of Arad „Vasile Goldis”, Romania ²Department of Microbiology, Western University of Arad „Vasile Goldis”, Romania ³Department of Urology, Western University of Arad „Vasile Goldis”, Romania
Abstract:	exual dysfunction have been frequently reported in patients with stroke. In recent studies it was shown that more than 50% of stroke patients reported post-stroke erectile dysfunction (ED). The aim of this study was to establish a correlation between prevalence and severity of ED and site location of stroke, and to assess the co-morbidities, medication and risk factors associated with post-stroke ED. At 153 patients (57.04 ± 6.54 years) with ischemic stroke, we evaluate the pre- and post-stroke prevalance of ED using the five-item International Index of Erectile Function questionnaire (IIEF5). Within 5 days of admission we determined the site location, and the stroke severity using the National Institute of Health Stroke Scale (NIHSS). The pre- and post-stroke data obtained were compared with those of 30 control persons (52.27 ± 8.35), and we compared the prevalence of ED with stroke location. The IIEF5 scores were much lower [median 17 interquartile range (IQR) 10-20] post stroke than pre-stroke (median 22 IQR 12-23) and lower than in control group (median 22.5 IQR 21-24). ED was associated with anterior cerebral artery infarction in 5/6, posterior cerebral artery infarction in 10/12, middle cerebral artery infarction in 70/93, basal ganglia infarction in 7/8, brain stem infarction in 13/16, cerebellar infarction in 6/14, and lesions in more than one region in 4/4 patients. The prevalence and severity of ED increase after stroke due to disruption of autonomous central structures. The depression, functional impairment, co-morbidities, and medication used after stroke may contribute to ED but must be evaluated in more specific patients group.
Keywords:	erectile dysfunction, IIEF5, ischemic stroke, ED prevalence, autonomic pathways, diabetes
References:	1.NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence (1993). JAMA 270 (1):83–90 2.Bener A, Al–Hamaq AO, Kamran S et al (2008) Prevalence of erectile dysfunction in male stroke patients, and associated co-morbidities and risk factors. Int Urol Nephrol 3.Monga TN, Ostermann HJ (1998) Sexuality and sexual adjustment in stroke patients. Phys Med Disabil Rehabil State Art Rev 20:317–329 4. Korpelainen JT, Nieminen P,Myllyla VV (1999) Sexualfunctioning among stroke patients and their spouses. Stroke 30(4):715–719 5.Hilz MJ (2008) Female and male sexual dysfunction. In: Low PA (ed) Clinical autonomic disorders. Lippincott Williams & Wilkins, Philadelphia, pp 657–711 6. Kasner SE (2006) Clinical interpretation and use of stroke scales. Lancet Neurol 5(7):603–612. doi:10.1016/s1474-4422 (06)70495-1 7. Bagby RM, Ryder AG, Schuller DR, Marshall MB (2004). "The Hamilton Depression Rating Scale: has the gold standard become a lead weight?". American Journal of Psychiatry 161 (12): 2163–77 8. Vroege JA (1999) The sexual health inventory for men (IIEF-5).Int J Impot Res 11(3):177 9. Kimura M, Murata Y, Shimoda K, Robinson RG (2001) Sexual dysfunction following stroke. Compr Psychiatry 42(3):217–222.doi:10.1053/comp.2001.23141 10. Pistoia F, Govoni S, Boselli C (2006) Sex after stroke: A CNS only dysfunction? Pharmacol Res 54(1):11–18. doi:10.1016/j.phrs.2006.01.010 11. Ryu JK, Jin HR, Yin GN, Kwon MH, Song KM, Choi MJ, Park JM, Das ND, Kwon KD, Batbold D, Lee T, Gao ZL, Kim KW,Kim WJ, Suh JK (2013) Erectile dysfunction precedes other systemic vascular diseases due to incompetent cavernous endothelial cell-cell junctions. J Urol 190(2):779–789. doi:10.1016/j.juro.2013.02.100 12. Thompson IM, Tangen CM, Goodman PJ, Probstfield JL,Moinpour CM, Coltman CA (2005) Erectile dysfunction and subsequent cardiovascular disease. JAMA 294(23):2996–3002.doi:10.1001 /jama.294.23.2996 13. Giuliano F, Rampin O (2004) Neural control of erection. Physiol Behav 83(2):189–201. doi:10.1016/ j.physbeh.2004.08.014 14. Duits A, van Oirschot N, van Oostenbrugge RJ, van Lankveld J (2009) The relevance of sexual responsiveness to sexual function in male stroke patients. J Sex Med 6(12):3320–3326. doi:10.1111/j.1743-6109.2009.01419.x 15. Temel Y, Hafizi S, Beuls E, Visser-Vandewalle V (2005) The supraspinal network in the control of erection. Expert Opin Ther Targets 9(5):941–954. doi:10.1517/14728222.9.5.941 16. Hilz MJ, Dutsch M, Perrine K, Nelson PK, Rauhut U, Devinsky O (2001) Hemispheric influence on autonomic modulation and baroreflex sensitivity. Ann Neurol 49(5):575–584 17. Oppenheimer S (2006) Cerebrogenic cardiac arrhythmias: cortical lateralization and clinical significance. Clin Auton Res16:6–11. doi:10.1007/s10286-006-0276-0
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