Neurogenic Sexual Dysfunction Treatment: A Systematic Review
Abstract
CONTEXT
The genesis of neurogenic sexual dysfunction (NSD) can be central, peripheral, or both. The correct stratification of the level of sexual dysfunction allows the clinician to choose the best type of treatment, in order to reduce sexual complaints.
OBJECTIVE
The aim of our review is to focus on the management of NSD due to central nervous system disorders and peripheral neuropathy.
EVIDENCE ACQUISITION
A systematic review of the English-language literature was completed until July 2019 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The following terms were included: [(neurogenic sexual dysfunction) OR neurogenic erectile dysfunction)] AND (treatment OR management). An Excel file was created respecting the following criteria: participants, interventions, comparators, outcomes, and study design (PICOS).
EVIDENCE SYNTHESIS
Overall, from 505 identified records, 52 full-text articles were assessed for eligibility. Finally, 46 original researches were included in quantitative analysis.
CONCLUSIONS
The phosphodiesterase type 5 inhibitors sildenafil, tadalafil, and vardenafil were proved to be effective and safe in first-line therapy of erectile dysfunction caused by neurogenic disorders. In addition, intracavernous injections of prostaglandin E1, papaverine, or phentolamine and vacuum systems have been a mainstay of second-line treatment for NSD, extremely successful in the spinal cord injury population. Surgical…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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