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首页> 外文期刊>The journal of sexual medicine >Sexual dysfunction induced by intrathecal baclofen administration: Is this the price to pay for severe spasticity management?
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Sexual dysfunction induced by intrathecal baclofen administration: Is this the price to pay for severe spasticity management?

机译：鞘内注射巴氯芬引起的性功能障碍：这是应对严重痉挛进行治疗的代价吗？

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Introduction: Intrathecal administration of baclofen (ITB) is widely recognized as an effective treatment for severe spasticity of both spinal and supraspinal origin with fewer side effects. The lower drug dosages used for spinal intrathecal administration, acting directly on the receptor sites, result in greater therapeutic efficacy with less systemic toxicity than with oral preparations. Aim: This study aims to prospectively evaluate the effects of ITB on erectile function in male patients affected by severe spasticity. Methods: Twenty adult male patients, with a 34.85±10.27 mean age, affected by severe spasticity mainly due to spinal cord lesions (10 traumatic, three vascular, six degenerative, and one congenital in origin) and treated with ITB, were enrolled in the study. All participants underwent specific clinical scales to evaluate force, muscle tone, cognition and mood, and specific sexual questionnaires, including an accurate semi-structured interview. Main Outcome Measure: The International Index of Erectile Function (IIEF) was used to evaluate sexual function before and after pump implantation. Results: A comparative analysis of the neurological scales and psychometric scores at T1 (baseline) and T2 (follow-up) showed statistically significant differences before and after pump implantation. In particular, we noted a significant decrease in the IIEF median scores (from 0.42±0.07 to 0.14±0.02, P value<0.0001) and a correlation between ITB dosage and IIEF scores (ρ=-0.60; P<0.05). Conclusions: This study supports previous findings on a possible negative effect of ITB on sexual function, with regard to erection. Patients who are considering ITB for treatment of severe spasticity should be informed about possible but reversible sexual side effects, especially at higher dosage. Future studies with larger samples should be fostered to confirm these findings for a better management of these, often young, patients.
机译：简介：鞘内施用巴氯芬（ITB）被认为是治疗脊柱和脊柱上肌源性严重痉挛且副作用较少的有效疗法。直接作用于受体部位的脊髓鞘内给药所用的较低药物剂量比口服制剂可产生更高的疗效，且全身毒性更小。目的：本研究旨在前瞻性评估ITB对严重痉挛影响的男性患者勃起功能的影响。方法：20例成年男性患者，平均年龄34.85±10.27岁，主要由于脊髓损伤（10例外伤，3例血管，6例变性，1例先天性脊髓损伤）而遭受严重痉挛，并接受ITB治疗。研究。所有参与者均接受了特定的临床量表，以评估力量，肌肉张力，认知和情绪以及特定的性问卷，包括准确的半结构式访谈。主要观察指标：国际勃起功能指数（IIEF）用于评估泵植入前后的性功能。结果：对T1（基线）和T2（随访）神经系统量表和心理测验得分的比较分析显示，在泵植入前后，神经统计量表和心理测验得分存在统计学差异。特别是，我们注意到IIEF中位数得分显着下降（从0.42±0.07降至0.14±0.02，P值<0.0001），ITB剂量与IIEF得分之间存在相关性（ρ= -0.60; P <0.05）。结论：这项研究支持以前关于勃起对ITB可能对性功能产生负面影响的发现。正在考虑使用ITB治疗严重痉挛的患者应被告知可能的但可逆的性副作用，尤其是高剂量时。应鼓励将来进行更大样本的研究，以证实这些发现，以便更好地管理这些患者（通常为年轻患者）。

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