The paucity of medical literature regarding sexuality following GBS suggests that sexual dysfunction in men is not a medical concern following recovery from this illness. However, during the past decade or so there has been an increasing body of medical literature indicating that most men who suffer from impotence have an organic basis for their problem. The causes, authorities conclude, could be as a result of decrease in the production of the male hormone, testosterone, or a decrease in the arterial blood supply to the penis, or damage or injury to nerve fibers that innervate muscle players in the arteries and veins that control blood flow in the penis.
Since GBS is an acute neurological disease that affects the sensory, autonomic and motor portions of the peripheral nervous system, we conducted a study to learn if there was an increased incidence of impotence in men following recovery from GBS. The study was done by a mailed survey in 1994-95. 10,000 questionnaires were distributed by the GBSFI with the help of Bob and Estelle Benson and with the help of John Larkin, our GBS liaison in England. We received 754 usable replies formed the basis of our study. This type of survey depends on a voluntary response to our questionnaire. Therefore, the results of our study may not apply to all men who have recovered from GBS.
Statistics from the Kinsey report and from a recent NIH symposium show that 10% of the male populations over 20 years old are impotent. Since the incidence is age weighted, the largest incidence of erectile dysfunction is found in the older male population.
Because our survey had a large number of men (122 of 396) over the age 65, we did a separate study of our population of men over 65 and our population who were 55 years and younger.
Twenty percent of the men over 65 (24 of the 122) reported they had erectile dysfunction problem prior to GBS. This is in line with the Kinsey’s findings. Howerever, following GBS, 74 of the 122 (61%) reported problems of impotence. Forty-one of the 175 men under age 55 (23%) were impotent following GBS compared to a rate of 6.7% in the same age group population in the Kinsey report.
In any age group category, 20-30, 31-40, 41-55, 56-65, and over 65 in our survey the rate of impotence was significantly higher than the matched age group in the general population as reported by Kinsey.
When the population of male respondents was restudied looking at the degree of residual disability following GBS, there was a striking difference between the group who had no residual disability following GBS or only mild residual disability and the group who reported severe or moderate residual disability. In the men 55 and below, 17 of 41 (41% in the moderate group) and nine of 20 (45% in the severe group) were impotent. In the over 65 group of men, our study showed a 61% and 71% incidence of impotence in those with moderate and severe residual respectively.
In both age groups those reporting moderate residual disability and that reporting server residual disability had the same rate of impotence statistically.
The only medical condition that seemed to be an added risk for impotence was diabetes. Though in our base of 396 men there were only 18 who had diabetes (not enough to draw any statistically significant result) 50% were impotent after GBS.
There was nothing in our date to suggest that depression or other psychological factors played a primary role in the high incidence of impotence following recover from GBS.
As a result of our study, we have concluded that GBS has a significant effect on male sexual function following recovery from the acute phase of the disease. The incidence of impotence exceeds the general male population in any age group.
Since the majority of men who are impotent have an organic cause for their erectile dysfunction (and GBS must now be included in the list of organic causes) men who suffer from impotence should seek appropriate medical help. Not all medical therapies are completely successful, but today there are many new urologic approaches to the problem of erectile dysfunction in men.