Prevalence of Erectile Dysfunction in HTLV-1–Infected Patients and Its Association With Overactive Bladder

Objectives To determine the prevalence of erectile dysfunction (ED) in human T-cell lymphotropic virus type I (HTLV-I)-infected patients, and its association with overactive bladder (OB). Methods In a cross-sectional study, 111 male patients with positive serology for HTLV-I (by enzyme-linked immunosorbent assay and Western blot) were examined between October 2003 and December 2006. Exclusion criteria were age 80 years, other neurological diseases, penile prosthesis, neoplasm, and psychological and mental disease. Patients were evaluated by a urologist and neurologist. ED was determined by application of the abridged form of 5-item International Index of Erectile Function (IIEF-5). ED was defined as IIEF-5 ≤ 21. OB was determined by International Continence Society criteria. Using the Expanded Disability Status Scale (EDSS) to determine disautonomy status, a neurologist classified all patients as either asymptomatic carriers (EDSS = 0), “oligosymptomatic myelopathy” (EDSS > 0 e ≤ 2), or HTLV-1–associated myelopathy/tropical spastic paraparesis (HAM/TSP); (EDSS > 2). Diagnosis of HAM/TSP was performed according to World Health Organization recommendations. Results Of the total of 111 patients, 6 were excluded and 105 were analyzed. The mean age was 48 ± 10.7 years. ED was observed in 55.2%. ED was documented in all patients who had HAM/TSP, in 79% of the group with EDSS > 0 and ≤2, and in 35.9% of HTLV-1–infected individuals with EDSS = 0. OB was detected in 93.75%, 33.3%, and 4.6%, respectively. Moreover, there was an association observed between ED and OB. Conclusions ED is a frequent disease in HTLV-I-infected individuals, and the prevalence is directly correlated to the degree of neurological disability measured by EDSS. ED was strongly associated with OB symptoms.