Restoration of sexual activity in patients with chronic hydrocephalus after shunt placement

Paolo Missori, Antonio Scollato, Rita Formisano, Antonio Currà, Concetta Mina, Massimo Marianetti, Filippo Maria Polli, Simone Peschillo, Sergio Paolini, Alessandro Frati, Massimo Miscusi

Research output: Contribution to journalArticlepeer-review


Background: Chronic (normotensive or low pressure) hydrocephalus is characterized clinically by gait disturbance, cognitive and urinary impairment, known as Hakim's triad. Nothing has been reported about impairment in sexual function, which could involve both the patient and the patient's partner. Methods: Out of 97 patients undergoing shunt placement for chronic hydrocephalus, 28 male patients (28.8%) referenced sexual dysfunction before operation. In these cases, we performed a preoperative and postoperative survey of sexual activity. Results: In the preoperative period, all 28 patients reported having no sexual activity or arousal, from 2 to 4 years before the operation. Following shunt placement, 22/28 (78.5%) of patients regained variable sexual desire within a period ranging from 3 to 8 weeks, affording normal sexual activity with their partner. Conclusions: Sexual dysfunction can be part of the very early clinical background in patients with Hakim's triad and neuroradiological imaging compatible with chronic hydrocephalus. Restoration of sexual ability and arousal should be considered among the postoperative goals in these cases, together with improvements in cognition, gait, and urinary continence.

Original languageEnglish
Pages (from-to)1241-1244
Number of pages4
JournalActa Neurochirurgica
Issue number10
Publication statusPublished - Oct 2009


  • Arousal
  • Cerebral blood flow
  • Chronic hydrocephalus
  • Sexual

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery


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