Laboratory of Neuromuscular & Cardiovascular Study of Motion (LANECASM), University of West Attica, Athens, Greece.
Second Dept of Neurology, Attikon University Hospital, National & Kapodistrian University of Athens, Rimini 1, 12462, Athens, Greece.
Neurol Sci. 2023 Mar;44(3):873-880. doi: 10.1007/s10072-022-06572-0. Epub 2022 Dec 31.
Multiple sclerosis (MS) is the most common chronic inflammatory demyelinating disease of the central nervous system (CNS). The most common clinical manifestations of MS are spasticity, pain, vesico-urethral disorders, cognitive impairments, chronic fatigue and sexual dysfunction. This review aims to explore the possible therapeutic options for managing sexual dysfunction in people with MS (PwMS).
A thorough search of the PubMed Medline database was performed. Records were limited to clinical studies published between 01/01/2010 up to 01/01/2022. The results were screened by the authors in pairs.
The search identified 36 records. After screening, 9 records met the inclusion-exclusion criteria and were assessed. The pharmacological approaches investigated the effectiveness of sildenafil, tadalafil and onabotulinumtoxinA. Of the interventional studies the non-pharmacological investigated, the effectiveness of aquatic exercises, the application of pelvic floor exercises,the combination of pelvic floor exercises and mindfulness technique, the combination of pelvic floor exercises and electro muscular stimulation with electromyograph biofeedback, the application of yoga techniques and the efficacy of assistive devices like the clitoral vacuum suction device and the vibration device.
The management of sexual dysfunction in PwMS needs to be further investigated. A team of healthcare professionals should be involved in the management of SD in order to address not only the primary (MS-related) SD symptoms but the secondary and tertiary as well. The main limitations that were identified in the existing literature were related to MS disease features, sample characteristics and evaluation tools and batteries.
多发性硬化症（MS）是中枢神经系统（CNS）最常见的慢性炎症性脱髓鞘疾病。MS 最常见的临床表现是痉挛、疼痛、膀胱尿道障碍、认知障碍、慢性疲劳和性功能障碍。本综述旨在探讨治疗多发性硬化症患者（PwMS）性功能障碍的可能选择。
对 PubMed Medline 数据库进行了全面检索。记录仅限于 2010 年 1 月 1 日至 2022 年 1 月 1 日期间发表的临床研究。作者对结果进行了配对筛选。
搜索确定了 36 条记录。经过筛选，有 9 条记录符合纳入排除标准并进行了评估。所研究的药理学方法研究了西地那非、他达拉非和奥纳博毒素 A 的有效性。在非药物干预的研究中，研究了水上运动、骨盆底运动的应用、骨盆底运动和正念技术的结合、骨盆底运动和电肌肉刺激与肌电图生物反馈的结合、瑜伽技术的应用以及辅助设备（如阴蒂真空抽吸装置和振动装置）的疗效。
需要进一步研究 PwMS 性功能障碍的管理。应该由一组医疗保健专业人员参与 SD 的管理，以解决不仅是原发性（与 MS 相关）SD 症状，还有继发性和三级症状。现有文献中的主要限制与 MS 疾病特征、样本特征以及评估工具和电池有关。
