Prevalence of erectile dysfunction in HTLV-1-infected patients and its association with overactive bladder.

OBJECTIVES

To determine the prevalence of erectile dysfunction (ED) in human T-cell lymphotropic virus type I (HTLV-I)-infected patients, and its association with overactive bladder (OB).

METHODS

In a cross-sectional study, 111 male patients with positive serology for HTLV-I (by enzyme-linked immunosorbent assay and Western blot) were examined between October 2003 and December 2006. Exclusion criteria were age <18 and >80 years, other neurological diseases, penile prosthesis, neoplasm, and psychological and mental disease. Patients were evaluated by a urologist and neurologist. ED was determined by application of the abridged form of 5-item International Index of Erectile Function (IIEF-5). ED was defined as IIEF-5 <or= 21. OB was determined by International Continence Society criteria. Using the Expanded Disability Status Scale (EDSS) to determine disautonomy status, a neurologist classified all patients as either asymptomatic carriers (EDSS = 0), "oligosymptomatic myelopathy" (EDSS > 0 e <or= 2), or HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP); (EDSS > 2). Diagnosis of HAM/TSP was performed according to World Health Organization recommendations.

RESULTS

Of the total of 111 patients, 6 were excluded and 105 were analyzed. The mean age was 48 +/- 10.7 years. ED was observed in 55.2%. ED was documented in all patients who had HAM/TSP, in 79% of the group with EDSS > 0 and <or=2, and in 35.9% of HTLV-1-infected individuals with EDSS = 0. OB was detected in 93.75%, 33.3%, and 4.6%, respectively. Moreover, there was an association observed between ED and OB.

CONCLUSIONS

ED is a frequent disease in HTLV-I-infected individuals, and the prevalence is directly correlated to the degree of neurological disability measured by EDSS. ED was strongly associated with OB symptoms.