Erectile Dysfunction (ED) after Ischemic Stroke - Association between Prevalence and Localization of Lesion (P07.025)

Abstract

Objective: To assess ED prevalence before and after ischemic stroke and associate ED with stroke location. Background Stroke may cause or worsen erectile dysfunction (ED). ED prevalence and association with the location of stroke lesions is not well established. Design/Methods: In 56 men, aged 64.39±10.64 years, who had ischemic stroke within 24 months before evaluation, we determined ED prevalence before and after stroke using the five item International Index of Erectile Function (IIEF-5) ranging from 1 (poorest score) to 25 (optimal score). We compared pre- and post-stroke IIEF-5-scores (Wilcoxon test; significance assumed for p Results: 46/56 (82.14%) patients reported ED after stroke vs. 27/56 (48.21%) patients before stroke. IIEF-5-values decreased from 22.5 (median; inter-quartile range (IQR) 19-24) before stroke to 14.5 (median; IQR 4-20) after stroke (p=0.0001). 32/56 (57.14%) patients had middle cerebral artery (MCA) stroke, 5/56 (8.93%) had posterior cerebral artery (PCA) stroke, 1/56 (1.79%) had anterior cerebral artery (ACA) stroke, 7/56 (12.5%) had brainstem infarction and 4/56 (7.14%) had ischemic lesions in more than 1 territory. ED was associated with MCA-infarction in 26/32 (81.25%) patients, PCA-infarction in 4/5 (80%) patients, ACA-infarction in 1/1 (100%) patient, brainstem-infarction in 7/7 (100%) patients, lesions in more than 1 region in 3/4 (75%) patients. Conclusions: Already before stroke, our patients had a high ED prevalence suggesting possible associations between ED and stroke risk factors. Stroke increases ED prevalence and severity as shown by deteriorating IIEF-5-values. MCA stroke was most common (32/56 patients) and thus most frequently associated with ED (26/32 patients). However, the relative risk of developing ED after stroke seems highest after brainstem infarction (7/7 patients), while the number of ACA infarctions was too low to determine the risk of ED development. Disclosure: Dr. Hilz has received personal compensation for activities with Genzyme Corporation and International Brain Research Foundation, Inc. as a speaker and/or consultant.Dr. Hilz has received research support from Genzyme Corporation and International Brain Research Foundation, Inc. Dr. Schramm has nothing to disclose. Dr. Cordel has nothing to disclose. Dr. Staykov has nothing to disclose. Dr. Pauli has nothing to disclose. Dr. Kolominsky-Rabas has nothing to disclose. Dr. Schwab has nothing to disclose. Dr. Wagner has nothing to disclose.