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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Erectile dysfunction is the most prevalent sexual dysfunction in neurogenically disabled men. Studies of rehabilitation patients indicate that the restoration of sexual functioning is considered an important priority. This article reports on a pilot study of vacuum tumescence constriction therapy as a noninvasive method for use by a population with traumatic or nontraumatic neurologic disorders such as spinal cord injury, stroke, multiple sclerosis, and diabetes mellitus. Of the 30 patients who participated in the study, 17 purchased the device and over 50% of them reported using the device on a long-term basis. Frequency of coitus increased from 0.3/wk to 1.5/wk. Included in the study are methods used by patients to integrate the device into their sex life, the role of the patient's partner in the decision to purchase the device, and the rate of partner satisfaction. There were no reports of substantial morbidity. Thus, this method shows promise as a noninvasive treatment for men who are moderately to severely neurogenically disabled.
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PMID:Noninvasive treatment for erectile dysfunction in the neurogenically disabled population. 140 45

Sexuality concerns of the post-stroke patient often are overlooked in the clinical setting during rehabilitation and post-discharge care. Research has indicated that patients welcome frank and open discussion of the topic, although it seldom occurs. Research findings also indicate that changes in sexuality after a stroke often are due to changes in role function because of the increased dependency of the afflicted partner. This article discusses the research related to sexuality in the post-stroke patient, as well as indicators of sexual dysfunction in this population. Research findings are related to nursing care. Specific patient examples are given, along with suggestions for incorporating assessment of sexuality concerns into nursing care of the post-stroke patient.
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PMID:Sexuality concerns of the post-stroke patient. 266 25

If the right hemisphere is dominant for activation and this capacity is critical for normal sexual function, one might expect to find a greater incidence of impaired sexual function after right than after left hemisphere stroke. We found that the prevalence of major sexual dysfunction was significantly greater after right (9/12) than after left (4/14) hemisphere stroke in 26 men with unilateral stroke. These data are consistent with the hypothesis that activation is critical for sexual function as well as the hypothesis that the right hemisphere is dominant for sexual function.
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PMID:Male sexual function. Impairment after right hemisphere stroke. 375 64

In a consecutive series of 51 one-stroke hemiplegics some aspects of sexuality were investigated using structured interviews. Findings were related to treatment with anti-hypertensive drugs. In most subjects the site of brain lesion was visualized by X-ray methods. Moreover, in a sub-sample of 15 consecutive males LH, FSH and prolactin were assessed using standard clinical radioimmunoassay techniques. Serum testosterone including response to HCG-stimulation was also measured. Both in males and females frequency of intercourse and durations of foreplay and of intercourse were markedly reduced. For the males erectile problems were rare before but occurred for the majority after stroke. For the females, but not for the males, orgastic dysfunction was relatively common pre-stroke. After the stroke such dysfunction occurred for 75% of the females and 64% of the males. Partnership sexual drive also decreased. Each of the 15 males hormonally screened had values within the predicted normal and responses to HCG-stimulation were also adequate. Moreover, actual levels of hormones were associated neither with change in sexual function nor with the sexual function per se at the time of the investigation. Thus, in this sample hormonal disarrangement did not appear to be the cause of sexual dysfunction. Surprisingly, no association between erectile dysfunction and use of anti-hypertensive drugs occurred. We believe that sexual dysfunctions in hemiplegics may rather be explained in terms of coping than by endocrine deficits or by anti-hypertensive treatment.
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PMID:Sexuality after stroke with hemiplegia. I. Aspects of sexual function. 686 36

Aspects of sexual function, partnership responsiveness and fulfilment after stroke were, together with sexually performance orientated and stigmatic attitudes, investigated in 51 subjects. Erectile and orgastic spectatoring were frequent after stroke and were in the males significantly associated. Retarded ejaculation occurred for no males before but for 15% after the stroke. Marked decreases in different kinds of caressive behaviour were followed by discontentment and up to and about half the subjects felt that sexual partnership responsiveness had deteriorated. After the stroke the commonly occurring reduction in general sexual satisfaction was significantly associated with symptoms of increased sexual dysfunction, disturbed partnership responsiveness and reduced sexual fulfilment. The high prevalence of sexual maladjustment in stroke victims appears mostly to be psychogenic. Important precipitating factors are performance orientation and sexual stigmatism. Moreover, lack of sexual information and counselling may contribute to deterioration of partnership sexuality.
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PMID:Sexuality after stroke with hemiplegia. II. With special regard to partnership adjustment and to fulfilment. 686 37

Investigation of sexual interest, function and attitudes of 35 patients (24 men and 11 women) before and after stroke showed no significant changes in sexual interest or desire for either men or women. However, men experienced significant decrease in ability to achieve erection and to ejaculate, and all of the 5 women who were premenopausal at the time of stroke reported major alterations in menses. Only 1 woman reported orgasm following stroke. Nineteen (79%) of the men and eight (73%) of th women reported sexual function to be of importance to themselves while all of the men and eight (73%) of the women believed it to be of importance to others of their age. The findings from this small sample indicate that although the majority of stroke survivors maintain consistent levels of sexual desire and believe that sexual function is important, most will experience sexual dysfunction following stroke. The sexual problems experienced by post-stroke patients appear to be of sufficient magnitude and frequency to warrant further investigation.
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PMID:Sexual functioning in stroke survivors. 723 24

Emotional distress and interpersonal stress are extremely common in patients after myocardial infarction and typically lessen over several months. However, it is important for physicians to screen patients with CAD for certain conditions that may need further assessment and possible treatment by a mental health professional. The examination of the patient with CAD involves assessment of psychological functioning, including the patient's level of denial, anxiety, and depression; the presence of panic anxiety or depressive disorder; and neuropsychological functioning, including memory and concentration. Evaluation for the presence of persistent or excessive interpersonal strife, marital conflict, and sexual dysfunction is also important. Those with symptomatic anxiety, depression, or social or sexual dysfunction should be referred to a mental health professional who has expertise in working with CAD patients and is knowledgeable about a variety of psychosocial and psychopharmacological treatments. Patients with CAD who are unable to modify their cardiovascular risk factors satisfactorily after guidelines are clearly articulated should be referred to a center designed to help patients identify the obstacles to behavior change and to facilitate and maintain long-term adherence to these changes. Patients with CAD who are physiologically able to work but have marked work stress or a marked reluctance to return to work should be evaluated by a mental health professional.
Heart Dis Stroke
PMID:Prevention of disability due to cardiovascular diseases. 815 78

Type 2 diabetes mellitus, one of the most prevalent and disruptive diseases in our older population, occurs in approximately 10% of persons over age 65. Its cause is usually a combination of deficient insulin production and resistance to insulin. In approximately one-half of those with diabetes, symptoms occur slowly over time and escape diagnosis. Complications include cardiovascular disease with myocardial infarction and stroke, nephropathy, retinopathy, peripheral neuropathy, and sexual dysfunction. Risk factors include age, family history, obesity, and sedentary lifestyle. Screening and early diagnosis are important secondary means of prevention, but physicians should also think about primary prevention based on family history, diet, and physical activity.
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PMID:Type 2 diabetes: causes, complications, and new screening recommendations. I. 951 74

This study was undertaken to examine the prevalence of sexual dysfunction among 100 patients (75 men and 25 women) following stroke and its relationship to neuropsychiatric impairments or stroke characteristics. Forty-four men (58.6%) and 11 women (44.0%) reported dissatisfaction with their sexual functioning after stroke, as compared with only 16 men (21.3%) and five women (20.0%) before stroke. Twenty men (26.6%) and six women (24.0%) reported diminished libido after stroke as compared with eight men (10.6%) and seven women (28.0%) before stroke. Patients with sexual dysfunction had significantly more depressive symptoms among both males (P =.007) and females (P =.0005) and more impaired activities of daily living (ADL) in males (P =.0009). Based on logistic regression, the independent predictors of poststroke sexual dysfunction were Hamilton Rating Scale for Depression (HAM-D) score (odds ratio [OR] 1.55; 95% confidence interval [CI], 1.20 to 2.01), left hemisphere lesion (OR, 16.51; 95% CI, 2.34 to 116.25), and poststroke depression (OR, 8.09; 95% CI, 1.28 to 51.38). These data suggest that treatment of depression may have a significant beneficial effect on patients with sexual dysfunction. Our findings also suggest that left hemisphere lesions, for unknown reasons, play an important role in poststroke sexual dysfunction.
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PMID:Sexual dysfunction following stroke. 1134 41

Male sexual function requires an intricate interplay between the man and his environment. Cognitive integration and physiological response to sexual stimulation is dependent on complex neurologic functions that may be impaired by central or peripheral neurologic disorders. This article reviews the normal neuroanatomy of sexual functioning in men, and the epidemiology, pathophysiology and management of sexual dysfunction in spinal cord injury, cerebrovascular accident, multiple sclerosis and Parkinson's disease.
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PMID:[Male sexual dysfunction with spinal cord injury and other neurologic diseases]. 1247 15


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