title: Erectile Dysfunction in Individuals with Neurologic Disability: A Hospital-based Cross-sectional Study.
abstract: OBJECTIVE
  Neurogenic erectile dysfunction can be broadly defined as an inability to sustain or maintain a penile erection due to neurologic impairment. Sexual problems can occur due to any lesion affecting the central and peripheral nervous system. The aim of this study was to evaluate the prevalence and causes of erectile dysfunction in a group of hospital inpatients suffering from neurologic disorders.
  
  
  METHODS
  Three-hundred and twenty six male patients admitted to the Neurorehabilitation Unit of IRCCS Centro Neurolesi "Bonino-Pulejo" in Messina Italy from March 2012 to June 2013 were screened for erectile dysfunction using the International Index of Erectile Function questionnaire. The patients who reported erectile dysfuntion underwent vascular, neurophysiological, and hormonal testing, and were divided into two groups according to their lesion sites: G1 (lesions above the S2-S4 center) and G2 (lesions below the S2-S4 center).
  
  
  RESULTS
  Of the 326 admitted patients, 126 patients (38.6%), mean age of 54.56±11.74 years (age range 27-82 years), were affected by erectile dysfunction (i.e., scored ≤21). A statistically significant correlation between International Index of Erectile Function questionnaire scores and location of the neurologic lesions was observed in G2 (r=0.22) with an increased risk of erectile dysfuntion of around 2:1 (odds ratio=1.87) without influences related to aging.
  
  
  CONCLUSIONS
  The occurence of erectile dysfunction is significantly more prevalent among neurologically disabled men, particularly those with lesions below S2-S4, than among men without neurologic disability. Considering the prevalence of erectile dysfunction among neurologically disabled men, sexual functioning should be regularly evaluated during acute and long-term rehabilitation, and any existing sexual dysfunction should be addressed in the treatment plan.
authors.affiliation: Drs. Calabró, Naro, de Luca, Marullo, and Bramanti are with the IRCCS Centro Neurolesi "Bonino Pulejo" in Messina, Italy; and Dr. Gervasi is with the Torvergata University in Rome, Italy.
authors.forename: Rocco Salvatore
authors.initials: RS
authors.lastname: Calabrò
authors.affiliation: Drs. Calabró, Naro, de Luca, Marullo, and Bramanti are with the IRCCS Centro Neurolesi "Bonino Pulejo" in Messina, Italy; and Dr. Gervasi is with the Torvergata University in Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gervasi
authors.affiliation: Drs. Calabró, Naro, de Luca, Marullo, and Bramanti are with the IRCCS Centro Neurolesi "Bonino Pulejo" in Messina, Italy; and Dr. Gervasi is with the Torvergata University in Rome, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Naro
authors.affiliation: Drs. Calabró, Naro, de Luca, Marullo, and Bramanti are with the IRCCS Centro Neurolesi "Bonino Pulejo" in Messina, Italy; and Dr. Gervasi is with the Torvergata University in Rome, Italy.
authors.forename: Rosaria
authors.initials: R
authors.lastname: de Luca
authors.affiliation: Drs. Calabró, Naro, de Luca, Marullo, and Bramanti are with the IRCCS Centro Neurolesi "Bonino Pulejo" in Messina, Italy; and Dr. Gervasi is with the Torvergata University in Rome, Italy.
authors.forename: Michelangelo
authors.initials: M
authors.lastname: Marullo
authors.affiliation: Drs. Calabró, Naro, de Luca, Marullo, and Bramanti are with the IRCCS Centro Neurolesi "Bonino Pulejo" in Messina, Italy; and Dr. Gervasi is with the Torvergata University in Rome, Italy.
authors.forename: Placido
authors.initials: P
authors.lastname: Bramanti
keywords: Neurogenic erectile dysfunction; erectile dysfunction; quality of life; sexual health