Nerve damage under-diagnosed in ED cases

3 May 2024
Nerve damage under-diagnosed in ED cases
by George Atkinson

Peripheral nerve damage is a major contributor to erectile dysfunction (ED) but is rarely diagnosed, suggests a new Spanish study in the British Journal of Urology International. "Up to now the impact of damaged nerves in the peripheral nervous system on ED has been underestimated," says lead author Dr Consuelo Valles-Antu�a, from the Hospital Universitario Central de Asturias in Oviedo.

The researchers, including experts on both neurophysiology and urology, studied 90 consecutive patients with sexual problems recruited from the hospital's Department of Andrology.

ED was diagnosed in the usual manner and a range of neurophysiology tests were carried out to assess the presence of large and small fibre peripheral neuropathy. The key findings included:

• Interestingly, no significant correlation between ED and increasing age was found. In fact, younger patients had worse ED scores, which could be due to higher expectations or a higher number of organic risk factors.
• Just under a third of the patients had cardiovascular disease, 16 percent had nervous system risk factors and 16 percent had diabetes. Just over 7 percent had been diagnosed with mental health issues.
• Neurophysiological exploration confirmed that nearly 70 percent of patients had nerve damage. Of these, 61 percent had some type of peripheral neuropathy and eight per cent had myelopathy - problems with their spinal chord.
• Around 40 percent of the patients had polyneuropathy, which occurs when a number of the peripheral nerves throughout the body malfunction simultaneously. Nearly 15 percent had pudendal neuropathy, affecting the nerves in the pelvic region.

The study indicates that peripheral neuropathy is highly prevalent in patients with ED. "Men with more severe symptoms of peripheral neuropathy, which can be caused by disease, trauma or illness, had greater self-reported ED and required more aggressive treatment," noted Dr Valles-Antu�a. "Our findings underline the importance of clinicians carrying out neurophysiological tests on patients with ED, particularly in the pelvic area."

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Source: British Journal of Urology International