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1.
J Sex Med ; 16(11): 1763-1768, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31521570

RESUMO

INTRODUCTION: Erectile dysfunction (ED) is associated with neurological damage due to human T-lymphotropic virus 1 (HTLV-1) infection, but hormonal and psychogenic factors also cause ED. AIM: To evaluate the association of psychogenic and hormonal factors with ED in men infected with HTLV-1. METHODS: In this cross-sectional study, we compared total testosterone, follicle stimulating hormone, luteinizing hormone, prolactin, anxiety symptoms, depressive symptoms, and neurologic manifestations in HTLV-1-infected men with or without ED. The International Index of Erectile Function was used to determine the degree of ED. Participants were grouped according to Osame's Motor Disability Scale and the Expanded Disability Status Scale: HTLV-1-associated myelopathy or tropical spastic paraparesis (HAM/TSP), probable HAM/TSP, or HTLV-1 carrier. Chi-square and Fisher's exact tests were used to compare the groups, and regression analyses were used to show predictors of ED. MAIN OUTCOME MEASURE: Sexual hormonal levels, psychogenic factors, and neurologic disabilities were found to be associated with ED. RESULTS: ED was associated with age older than 60 years (P < .001), degree of neurologic involvement (P < .001), depression (P = .009), and anxiety (P = .008). In the multivariate analyses, only age and degree of neurological injury remained as risk factors for ED. CLINICAL IMPLICATIONS: Neurological manifestations are a stronger predictor of ED than hormonal and psychogenic factors in HTLV-1-infected men. STRENGTHS & LIMITATIONS: The statistical power of the study was limited due to the low number of participants, but neurologic manifestations were clearly associated with ED. There was no strong association between hormonal and psychogenic factors and ED. CONCLUSION: Hormonal and psychogenic factors did not show a strong association with ED in individuals with HTLV-1, but neurological manifestations were strongly associated with ED in these individuals. de Oliveira CJV, Neto, JAC, Andrade RCP, et al. Hormonal and Psychogenic Risk Factors for Erectile Dysfunction in Men with HTLV-1. J Sex Med 2019; 16:1763-1768.


Assuntos
Disfunção Erétil/epidemiologia , Infecções por HTLV-I/complicações , Comportamento Sexual , Adulto , Estudos Transversais , Depressão/epidemiologia , Pessoas com Deficiência , Vírus Linfotrópico T Tipo 1 Humano/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Motores/epidemiologia , Paraparesia Espástica Tropical/epidemiologia , Fatores de Risco
2.
J Sex Med ; 14(10): 1195-1200, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28827086

RESUMO

BACKGROUND: Erectile dysfunction (ED) occurs in more than 50% of patients with human T-cell lymphotropic virus type 1 (HTLV-1) infection. In the general population, atherosclerosis is the main risk factor related to ED. AIM: To compare the contribution of neurologic disorders from HTLV-1 with that of atherosclerosis as risk factors for ED in men with HTLV-1. METHODS: In this cross-sectional study, men 18 to 70 years old with HTLV-1 were classified into one of two groups according to the presence or absence of ED. They were compared for obesity, waist circumference, dyslipidemia, metabolic syndrome, diabetes mellitus, high blood pressure, and neurologic manifestations. Comparisons between proportions were performed using the χ2 or Fisher exact test. Logistic regression analysis was performed to identify predictors of ED. Subjects with HTLV-1 were classified into three groups based on Osame's Disability Motor Scale and the Expanded Disability Status Scale: (i) HTLV-1 carriers; (ii) probable HTLV-1-associated myelopathy or tropical spastic paraparesis; and (iii) definitive HTLV-1-associated myelopathy or tropical spastic paraparesis. The International Index of Erectile Function was used to determine the degree of ED. RESULTS: In univariate logistic regression, age older 60 years (P = .003), diabetes mellitus (P = .042), and neurologic disease (P < .001) were associated with ED. In the multivariate model, the odds of ED was highest in patients with neurologic disease (odds ratio = 22.1, 95% CI = 5.3-92.3), followed by high blood pressure (odds ratio = 6.3, 95% CI = 1.4-30.5) and age older than 60 years (odds ratio = 4.6, 95% CI = 1.3-17.3). CLINICAL IMPLICATIONS: In men infected with HTLV-1, neurologic dysfunction is a stronger predictor of ED than risk factors for atherosclerosis. STRENGTHS AND LIMITATIONS: The small number of patients limited the power of the statistical analysis, but clearly neurologic manifestations had a greater association with ED than risk factors for atherosclerosis, and there was no association between metabolic syndrome and severity of ED. CONCLUSION: Neurologic impairment is the major cause of ED in individuals infected with HTLV-1 and risk factors for atherosclerosis did not have a strong relation with ED in this population. de Oliveira CJV, Neto JAC, Andrade RCP, et al. Risk Factors for Erectile Dysfunction in Men With HTLV-1. J Sex Med 2017;14:1195-1200.


Assuntos
Disfunção Erétil/virologia , Infecções por HTLV-I/complicações , Vírus Linfotrópico T Tipo 1 Humano , Adulto , Idoso , Estudos Transversais , Humanos , Modelos Logísticos , Masculino , Síndrome Metabólica/complicações , Pessoa de Meia-Idade , Obesidade/complicações , Razão de Chances , Fatores de Risco , Circunferência da Cintura , Adulto Jovem
3.
Urology ; 89: 33-8, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26724409

RESUMO

OBJECTIVE: To evaluate the efficacy of physiotherapy for urinary manifestations in patients with human T-lymphotropic virus 1-associated lower urinary tract dysfunction. METHODS: Open clinical trial was conducted with 21 patients attending the physiotherapy clinic of the Hospital Universitário, Bahia, Brazil. Combinations of behavioral therapy, perineal exercises, and intravaginal or intra-anal electrical stimulation were used. RESULTS: The mean age was 54 ± 12 years and 67% were female. After treatment, there was an improvement in symptoms of urinary urgency, frequency, incontinence, nocturia, and in the sensation of incomplete emptying (P < .001). There was also a reduction in the overactive bladder symptom score from 10 ± 4 to 6 ± 3 (P < .001) and an increase in the perineal muscle strength (P <.001). The urodynamic parameters improved, with reduction in the frequency of patients with detrusor hyperactivity from 57.9% to 42.1%, detrusor-sphincter dyssynergia from 31.6% to 5.3%, detrusor hypocontractility from 15.8% to 0%, and detrusor areflexia from 10.5% to 0%, with positive repercussions in the quality of life in all patients. CONCLUSION: Physiotherapy was effective in cases of human T-lymphotropic virus 1-associated neurogenic bladder, reducing symptoms, increasing perineal muscle strength, and improving urodynamic parameters and quality of life.


Assuntos
Infecções por HTLV-I/complicações , Modalidades de Fisioterapia , Bexiga Urinaria Neurogênica/complicações , Bexiga Urinaria Neurogênica/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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