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Many sexual problems are either psychological, urological or
neurological. Neurological dysfunction may arise from damage to the
regional nerve, the spinal cord or the brain by trauma, infections,
tumors or stroke. Diabetes and alcoholism may disturb neurological
control.
Hormonal problems resulting in sterility and unsatisfactory
sex may be due to a brain tumor. Impotence is the most common presenting
problem. Antihypertensives and antiepileptics rarely cause impotence. In
some brain problems, patients exhibit hyper sexuality and inappropriate
sexual activities.
Urinary bladder control is affected in many neurological
problems and associated with sexual dysfunction. As the bladder fills
beyond it's capacity, the patient develops over flow incontinence as
happens in lumbosacral spinal cord or in peripheral nerve involvement.
Higher spinal cord involvement results in a shrunken bladder, premature
contraction of the bladder and incontinence.
Brain decides when to pass urine. When specific areas in the
brain are involved incontinence results. Incontinence at sleep may be an
early sign of seizure.
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