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Many sexual problems are either psychological, urological or neurological. Neurological dysfunction may arise from damage to the regional nerve, the spinal cord or the brain by trauma, infections, tumors or stroke. Diabetes and alcoholism may disturb neurological control.

Hormonal problems resulting in sterility and unsatisfactory sex may be due to a brain tumor. Impotence is the most common presenting problem. Antihypertensives and antiepileptics rarely cause impotence. In some brain problems, patients exhibit hyper sexuality and inappropriate sexual activities.

Urinary bladder control is affected in many neurological problems and associated with sexual dysfunction. As the bladder fills beyond it's capacity, the patient develops over flow incontinence as happens in lumbosacral spinal cord or in peripheral nerve involvement. Higher spinal cord involvement results in a shrunken bladder, premature contraction of the bladder and incontinence.

Brain decides when to pass urine. When specific areas in the brain are involved incontinence results. Incontinence at sleep may be an early sign of seizure.

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