Fletcher Sophie G, Castro-Borrero Wanda, Remington Gina, Treadaway Katherine, Lemack Gary E, Frohman Elliot M
Department of Urology, University of Texas Southwestern at Dallas, Dallas, TX 75390, USA.
Nat Clin Pract Urol. 2009 Feb;6(2):96-107. doi: 10.1038/ncpuro1298.
Multiple sclerosis (MS) is the most common cause of progressive neurological disability in young adults. In addition to spasticity, tremors, weakness, sensory disturbances, depression, cognitive problems, and bladder or bowel dysfunction, sexual dysfunction (SD) is also a prevalent and destructive manifestation of the disease that severely affects quality of life. Evaluation of this disorder requires insight into the primary (changes that directly affect libido, sexual response and orgasm due to direct damage to the nervous system), secondary (complaints which are related to the physical disability of MS, such as fatigue, muscle rigidity, weakness and spasms), and tertiary (emotional, social and cultural aspects of MS) components of MS-associated SD. Given the complexity and multifactorial nature of SD, a multidisciplinary approach is necessary when treating patients with MS. The aim of this Review is to provide a holistic approach to the evaluation and management of SD in patients with MS, incorporating the latest data from the fields of urology, neurology, nursing, social work, and psychology. What is currently known regarding the evaluation and management of SD in patients with MS will be presented from the perspective of these specialties.
多发性硬化症（MS）是年轻成年人进行性神经功能障碍最常见的病因。除了痉挛、震颤、虚弱、感觉障碍、抑郁、认知问题以及膀胱或肠道功能障碍外，性功能障碍（SD）也是该疾病一种普遍且具有破坏性的表现，严重影响生活质量。对这种障碍的评估需要深入了解与MS相关的SD的主要（由于神经系统直接受损而直接影响性欲、性反应和性高潮的变化）、次要（与MS身体残疾相关的主诉，如疲劳、肌肉僵硬、虚弱和痉挛）和第三（MS的情感、社会和文化方面）因素。鉴于SD的复杂性和多因素性质，在治疗MS患者时采用多学科方法是必要的。本综述的目的是提供一种整体方法来评估和管理MS患者的SD，纳入泌尿外科、神经科、护理、社会工作和心理学领域的最新数据。将从这些专业的角度介绍目前关于MS患者SD评估和管理的已知情况。
