Correlation of the Erectile Dysfunction with Lesions of Cerebrovascular Accidents

Abstract

Introduction The recent human and animal studies indicate that the central supraspinal systems controlling penile erection, which are localized predominantly in the parts of the frontal lobe and limbic system, are reported to be involved in erection. Aim The purpose of this study was to elucidate the correlation of the erectile dysfunction (ED) with lesions of cerebrovascular accidents (CVA). Methods Forty-four men were selected among the CVA patients who had visited our hospital between March and July 2006. The audiovisual sexual stimulation (AVSS) test was conducted using Rigiscan device on the patients, whose erectile domain score of the International Index of Erectile Function Questionnaire (IIEF) was less than 22. The criteria for adequate erectile function was the erectile events of >60% rigidity for ≥5 minutes. The CVA lesions were classified into frontal lobe, cortex except frontal lobe, basal ganglia, thalamus, and other area. Each CVA lesions of ED group and non-ED group were compared. Main Outcome Measure IIEF, AVSS using Rigiscan. Result Thirty-eight patients’ erectile domain score of IIEF were less than 22, and the AVSS test was conducted on them. Eighteen patients showed no ED, and 20 patients showed ED. The mean age of the ED group was 60.40 ± 2.2, and the mean age of non-ED group was 55.29 ± 1.85. There was no statistically significant difference between the mean age of both groups (P = 0.081). As each CVA lesions of both groups were compared, the CVA lesions of the thalamic area in the ED group were significantly more than in the non-ED group (P = 0.010). Conclusions Patients (47.4%) who were suggestive of ED in the IIEF has no ED in the AVSS test. The patients who had CVA lesions in the thalamic area more commonly showed ED than the patients with CVA lesions of any other areas.

Male Sexual Disorders Following Stroke: An Overview

“…In particular, a decrement of sexual desire was associated with a stroke lesion on the left basal ganglia; patients with lesions in the right cerebellum experienced significant ejaculatory disorders; and patients with lesion in the right pons were associated with a decrease in the International Index of Erectile Function (IIEF) score. Jeon, Yoo, Kim, Kim, and Lee (2009) demonstrated that patients with ischemic lesions of the thalamus showed a more severe degree of erectile dysfunction (ED) than those with cerebral infarctions located in any other areas. This would point out the possible role of thalamus in human penile erection supporting those preclinical studies that suggested how thalamic caudal and lateral intralaminar nuclei are involved in processing the sexual outflow from the spinothalamic pathway towards the preoptic area, amygdala, temporal lobe, and the frontal cortex.…”

Audiovisual Sexual Stimulation and RigiScan Test for the Diagnosis of Erectile Dysfunction

“…Penile erection is a complex event controlled by vascular, hormonal, and neurological systems. [ 1 ] Depending on the context in which penile erection occurs, it is generally accepted that different central and peripheral neural and/or humoral endocrine mechanisms may participate in the regulation of this sexual response, often in a very complex fashion. [ 2 3 4 ] Erectile dysfunction (ED) is a men's health issue that is receiving overwhelming attention in recent years.…”

Impaired sexual activity in young ischaemic stroke patients: an observational study

“…Post‐stroke ISA is thought to be caused by several etiologies and involves a complex interplay between psychological and organic factors . The factors reported to date include several specific characteristics of stroke (right hemisphere injury , thalamic lesions , motor impairment ), previous hypertension, diabetes and cardiac disease , various psychosocial factors (the relationship with the spouse, the fear of a new stroke ) and depression . Age is also reportedly an important factor in post‐stroke ISA .…”