Sexual Dysfunction (Male)

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Superficial Siderosis patient erectile dysfunction is the result of autonomic peripheral neuropathy damage of the nerves in the pelvic and sacral regions. This includes problems achieving or maintaining an erection or ejaculation problems stemming from small fiber nerve damage or sensory nerve dysfunction.

Almost 38 percent of the 90 men recruited for the study, Peripheral neuropathy: an underdiagnosed cause of erectile dysfunction, were found to have polyneuropathy, which occurs when a number of the peripheral nerves throughout the body malfunction simultaneously. Of these nine percent had small fiber neuropathy, damage to the small unmyelinated peripheral nerve fibers and just over 14 percent had pudendal neuropathy, affecting the somatic nerve in the pelvic region.

Researchers have uncovered clear links between erectile dysfunction (ED) and peripheral neuropathy. This study of 90 patients shows that 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. The findings underline the importance of clinicians carrying out neurophysiological tests on patients with ED, particularly in the pelvic area.¹

Typically, men have two types of erections, psychogenic and reflex. A reflex erection is involuntary and can occur without sexual or stimulating thoughts. The nerves that control a man’s ability to have a reflex erection are located in the sacral area (S2–S4) of the spinal cord. Psychogenic erections result from the brain sending arousing messages through the nerves of the spinal cord that exit at the T10-L2 levels.²

A urologist should be consulted regarding managing ED from autonomic peripheral neuropathy. The pathophysiology and treatment path for Superficial Siderosis patients will be similar to the treatment of ED for those suffering from a spinal cord injury.

Updated June 18, 2018

¹Consuelo Valles-Antuña, Jesus Fernandez-Gomez, Fernando Fernandez-Gonzalez. Peripheral neuropathy: an underdiagnosed cause of erectile dysfunction. BJU International, 2011; 108 (11): 1855 DOI: 10.1111/j.1464-410X.2011.10126.x
²https://www.christopherreeve.org