“The study below documents how closely related bladder and sexual dysfunction are. This should be something of a red flag for doctors and nurses seeing MSers. If an MSer complains of bladder problems we should ask about sexual problems. Why? Because we have treatments for sexual dysfunction and sexual dysfunction contributes to poor quality of life. From an anatomical perspective it is not surprising that bladder and sex go together; the neuronal pathways are both long and tend to be involved by spinal cord lesions. The following are two of the most commonly used surveys to screen men and woman for sexual dysfunction. The one for woman has been open for many months and has over 70 respondents already. It would be interesting to compare the sexes; so if you have time could you please take a few minutes to complete one of these surveys. I am aware that these surveys are not high science, but they do highlight the how common certain problems are in MS and the need for treatment. By completing the relevant survey you will also learn about what signs to look for and how to discuss your problems, if you have any, with your nurse of neurologist.”
Epub: Fragalà et al. Relationship between urodynamic findings and sexual function in multiple sclerosis patients with lower urinary tract dysfunction. Eur J Neurol. 2014 Nov 19. doi: 10.1111/ene.12595.
BACKGROUND AND PURPOSE: Sexual dysfunction (SD) is prevalent in MSers and affects quality of life. Furthermore, lower urinary tract dysfunction (LUTD) is common in MSers. Our aim was to determine the relationship between urodynamic findings and SD in a cohort of MSers with LUTD.
METHODS: From January 2011 to September 2013, 135 consecutive patients with MS in remission phase and LUTD underwent a first urodynamic examination, according to the International Continence Society criteria. Neurological impairment was assessed using the Expanded Disability Status Scale and SD was investigated with the Female Sexual Function Index (FSFI) or the International Index of Erectile Function (IIEF-15). Multivariate logistic regression analysis was performed to identify predictors of female SD (FSFI < 26.55) or moderate-severe erectile dysfunction (ED) (IIEF-EF ≤ 16), after adjusting for confounding factors including urodynamic findings.
RESULTS: Subjects with maximum detrusor pressure during involuntary detrusor contraction (PdetmaxIDC) ≥20.0 cmH2 O had lower IIEF-EF, IIEF overall satisfaction (IIEF-OS), FSFI-Arousal, FSFI-Lubrication and FSFI-Orgasm. Subjects with maximum cystometric capacity (MCC) ≥135 ml had higher IIEF-EF, intercourse satisfaction (IIEF-IS), orgasmic function (IIEF-OF), sexual desire (IIEF-SD), FSFI-Arousal, FSFI-Lubrication, FSFI-Orgasm, FSFI-Satisfaction and FSFI-Pain. On multivariate logistic regression analysis, PdetmaxIDC ≥20 cmH2 O [odds ratio (OR) 6.7; P < 0.05] and MCC <135 ml (OR 6.80; P < 0.05) were predictors of moderate-severe ED. In a model including all previous variables, compliance ≤3 ml/cmH2 O was an independent predictor of moderate-severe ED (OR 14.49; P < 0.01). No relationship was found between the previous variables and FSFI <26.55.
CONCLUSIONS: Neurogenic bladder is associated with SD in MS patients. The presence of PdetmaxIDC ≥20 cmH2 O, MCC <135 ml and compliance ≤3 ml/cmH2 O may significantly predict the presence of moderate-severe ED.