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Sexual problems in disorders of the nervous system. I. Anatomical and physiological aspects.

One of the most distressing aspects of chronic diseases of the nervous system is the loss or impairment of bladder, bowel, and sexual function. Patients are often willing to accept that they have lost the use of their legs, but it is the loss of social accep tability caused by the dysfunction of bladder and bowel, resulting in incontinence of urine and faeces, that causes them the most unhappiness. There are many published works on how the bowels and bladder may be managed, but there is a dearth of information on the sexual aspects. To deal adequately with the subject it is best to discuss, firstly, those patients who are likely. to be affected, secondly, the anatomy and physiology of the sexual act and its impairment in men and women with chronic diseases of the nervous system, and, thirdly, the practical aspects of intercourse, marriage, and pregnancy and labour.