Divisao de Urologia, Faculdade de Medicina do ABC, Santo Andre, SP, BR.
Divisao de Urologia, Associacao Brazileira de Esclerose Multipla (ABEM), Sao Paulo, SP, BR.
Clinics (Sao Paulo). 2019 Mar 14;74:e713. doi: 10.6061/clinics/2019/e713.
To assess the prevalence and interrelationship between lower urinary tract symptoms and sexual dysfunction in men with multiple sclerosis (MS).
In a cross-sectional study, we evaluated 41 men (mean age 41.1±9.9 years) with MS from February 2011 to March 2013, who were invited to participate irrespective of the presence of lower urinary tract symptoms or sexual dysfunction. Neurological impairment was assessed with the Expanded Disability Status Scale; lower urinary tract symptoms were evaluated with the International Continence Society male short-form questionnaire, and sexual dysfunction was evaluated with the International Index of Erectile Function. All patients underwent transabdominal urinary tract sonography and urine culture.
The mean disease duration was 10.5±7.3 years. Neurological evaluation showed a median Expanded Disability Status Scale score of 3 [2-6]. The median International Continence Society male short-form questionnaire score was 17 [10-25]. The median International Index of Erectile Function score was 29 [15-46]. Twenty-nine patients (74.4%) had sexual dysfunction as defined by an International Index of Erectile Function score <45. Voiding dysfunction and sexual dysfunction increased with the degree of neurological impairment (r=0.02 [0.02 to 0.36] p=0.03 and r=-0.41 [-0.65 to -0.11] p=0.008, respectively). Lower urinary tract symptoms and sexual dysfunction also displayed a significant correlation (r=-0.31 [-0.56 to -0.01] p=0.04).
Most male patients with MS have lower urinary tract symptoms and sexual dysfunction. The severity of the neurological disease is a predictive factor for the occurrence of voiding and sexual dysfunctions.
评估多发性硬化症（MS）男性患者下尿路症状与性功能障碍的患病率及其相互关系。
采用横断面研究，我们于 2011 年 2 月至 2013 年 3 月评估了 41 名男性（平均年龄 41.1±9.9 岁）MS 患者，邀请他们参加研究时并未考虑下尿路症状或性功能障碍的存在。神经功能缺损采用扩展残疾状态量表进行评估；下尿路症状采用国际尿控协会男性简短问卷进行评估，性功能障碍采用国际勃起功能指数进行评估。所有患者均接受经腹尿路超声检查和尿液培养。
平均病程为 10.5±7.3 年。神经学评估显示中位扩展残疾状态量表评分为 3 [2-6]。国际尿控协会男性简短问卷评分的中位数为 17 [10-25]。国际勃起功能指数评分为 29 [15-46]。29 名患者（74.4%）的国际勃起功能指数评分<45，存在性功能障碍。排尿功能障碍和性功能障碍随神经功能损伤程度增加而增加（r=0.02 [0.02 至 0.36]，p=0.03；r=-0.41 [-0.65 至 -0.11]，p=0.008）。下尿路症状和性功能障碍之间也存在显著相关性（r=-0.31 [-0.56 至 -0.01]，p=0.04）。
大多数男性多发性硬化症患者存在下尿路症状和性功能障碍。神经疾病的严重程度是发生排尿和性功能障碍的预测因素。
