Abstract:

Erectile dysfunction is a common problem in people with epilepsy(PWE). The etiology is multifactorial involving most epilepsy, antiepileptic drugs, and co-morbidity.  It is an extensive influence on the quality of life and well-being of patients and their partners. Apart from epileptic disease and antiepileptic drugs (AEDs) use, the general medical history with the question of other possible risk factors and the specific sexual history play the most important roles in the guideline-based diagnostics. In addition, a thorough clinical examination and specific laboratory tests should be carried out. The appropriate treatment to be provided for epileptic patients with erectile dysfunction (ED) requires evaluation according to patient requirements, the epileptic condition and comorbidities and the medicines available for managing epilepsy. Various approaches might be helpful for treatment of ED in PWEs. Contemporary treatment algorithms for ED involve the use of non-pharmacological therapies; psychotherapy, changes of AEDs and pharmacological therapies such as phosphodiesterase type 5 (PDE5) inhibitors and intracavernosal injection therapy of vasoactive agents, as well as vacuum erection devices and penile prosthesis implants in PWEs. The success rates are high in most cases. Every neurologist, urologist, andrologist and other practitioners of sexual medicine should have detailed knowledge in this field. This state-of- the art article evaluates current and emerging therapeutic options for ED problems in PWEs.

Keywords: Erectile dysfunction, sexual dysfunction, people with epilepsy