Stroke-related erectile dysfunction: Impact of the cerebrovascular stroke site on the degree of erectile dysfunction, total testosterone and prolactin levels

Background: Stroke is one of the major causes of permanent disability and mortality in the aging population worldwide. Reduced libido, and poor erection and ejaculation are among common poststroke sexual dysfunctions, which is due to multiple factors, including both organic and psychosocial factors.Objective: We designed the study in order to detect the presence of erectile dysfunction (ED) among male patients with stroke using the International Index of Erectile Function (IIEF-5) and correlate the site of the lesion with the degree of ED. Also, we evaluated the serum total testosterone and prolactin levels among those patients and correlated their levels with the degree of ED using IIEF-5.Patients and Methods: Eighty male patients with ischemic cerebrovascular stroke were included in the study. The patients were diagnosed and divided according to the brain site lesion of cerebrovascular stroke into seven groups. The stroke patients completed the IIEF-5. Serum testosterone and prolactin levels were obtained and compared.Results: The mean age of the patients was 55.35±3.68 years. ED was detected in 53 patients representing 66.3% with variable degrees of severity (22.5% mild, 6.3% mild to moderate, 7.5% moderate, and 30.0% severe), while 27 (33.8%) patients had no ED. The mean testosterone level was lower than normal in basal ganglion affection and multiple areas affection only, while the mean prolactin level was higher than normal in all groups.Conclusion: ED is a common problem that may follow cerebrovascular stroke. We do recommend that counseling by a trained professional should be made part of stroke rehabilitation