Sexual Dysfunction and PPS
Question: There is a disagreement between my doctors as to whether or not post-polio syndrome can contribute to a diagnosis of an erectile dysfunction. As an expert in PPS what is your opinion and reasons whether PPS can or can't contribute to erectile dysfunction.
Dr. Bruno’s Response: The process of producing an erection is a complex ballet between sympathetic, parasympathetic and motor neurons in the spinal cord as well as autonomic nervous system centers in the brain. It has been known since the 1940s that the poliovirus damages all of these areas, so the question is a good one.
Since my specialty is the autonomic nervous system I have paid close attention to autonomic abnormalities in blood flow and the activity of the intestines and bladder in polio survivors. Over the past nearly 40 years studying polio survivors, we have seen slowing of stomach emptying and of the intestines that would be the result of poliovirus damage to the vagus/parasympathetic nerve.
During the acute phase of polio the most common “genital" symptom was urinary retention in both males and females. However, in recovered polio survivors, a percentage of women report lack of retention - usually “dribbling” - but not in excess of what one would expect in 60-plus year-old polio survivors. When patients ask me about urinary problems possibly being caused by polio, my answer always is that having had polio may make symptoms worse, but that polio/PPS is not the primary cause.
Assessing, evaluating and studying more than 7,000 polio survivors, I cannot identify even a handful of males who had erectile dysfunction.
But my answer would be the same I give to women: polio may make erectile dysfunction worse but it is not the primary cause.