NOCTURNAL PENILE TUMESCENCE AND RIGIDITY EVALUATION IN MEN WITH EPILEPSY

Purpose: Men with epilepsy appear to have an approximately fivefold in crease in risk of erectile dysfunction (ED). We attempted to determine whether ED in men with epilepsy was due to a physiological basis and whether erectile function could be adequately evaluated with an ambula tory nocturnal penile tumescence and rigidity monitor. Methods: The ph ysiologic integrity of the sexual response in men with epilepsy and ED was assessed with an ambulatory nocturnal penile tumescence and rigid ity monitor (NPTR). Six men with localization-related epilepsy of temp oral lobe origin (TLE) and ED, 2 men with TLE and normal sexual functi on, and 1 man with nonepileptic seizures (NES) and ED underwent evalua tion of nocturnal erections for at least 2 nights. Results: Five of 6 men with TLE and complaints of ED had abnormal ambulatory NPTR evaluat ions. All others had normal ambulatory NPTR. All abnormal evaluations showed reduced levels of rigidity, often with normal levels of tumesce nce. Conclusions: Previous studies have shown this abnormal ambulatory NPTR pattern to be associated with neurogenic rather than vasogenic E D. Therefore, epilepsy-related ED may have a substantial neurophysiolo gic component.