Rheumatology International

, Volume 38, Issue 1, pp 149–152 | Cite as

Parenchymal neuro-Behçet disease with erectile dysfunction and micturition disturbances: case report and literature review

  • Ali TaylanEmail author
  • Merih Birlik
Cases with a Message


Parenchymal neuro-Behçet disease (NBD) is a serious clinic condition with a sub-acute or chronic disease course that results in incapability through pyramidal tract involvement. Though well-known consequences can deter a patient’s life, both urinary symptoms and sexual dysfunction are underestimated complications of NBD and closely related in timing. Here, we report the case of a young male patient with parenchymal NBD who developed urinary incontinence and erectile dysfunction in addition to widespread pyramidal tract signs and symptoms. We discuss clinical features, prognosis and treatment of the case. A review of English literature was conducted for cases of concurrent urinary or sexual dysfunction complicating parenchymal-NBD.


Neuro-Behçet disease Urinary dysfunction Bladder Erectile dysfunction 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Ideguchi H, Suda A, Takeno M, Kirino Y, Ihata A, Ueda A, Ohno S, Baba Y, Kuroiwa Y, Ishigatsubo Y (2010) Neurological manifestations of Behçet’s disease in Japan: a study of 54 patients. J Neurol 257(6):1012–1020CrossRefPubMedGoogle Scholar
  2. 2.
    The Neuro-Behçet Study Group, Akman-Demir G, Serdaroglu P, Tasçi B (1999) Clinical patterns of neurological involvement in Behçet’s disease: evaluation of 200 patients. Brain 122:2171–2182CrossRefGoogle Scholar
  3. 3.
    Kirkali Z, Yigitbasi O, Sasmaz R (1991) Urological aspects of Behcet’s disease. Br J Urol 67:638–639CrossRefPubMedGoogle Scholar
  4. 4.
    Erdoğru T, Koçak T, Serdaroğlu P, Kadioğlu A, Tellaloğlu S (1999) Evaluation and therapeutic approaches of voiding and erectile dysfunction in neurological Behçet’s syndrome. J Urol 162(1):147–153CrossRefPubMedGoogle Scholar
  5. 5.
    International Study Group for Behçet’s Disease (1990) Criteria for diagnosis of Behçet’s disease. Lancet 335(8697):1078–1080Google Scholar
  6. 6.
    Siva A, Kantarci OH, Saip S, Altintas A, Hamuryudan V, Islak C, Koçer N, Yazici H (2001) Behçet’s disease: diagnostic and prognostic aspects of neurological involvement. J Neurol 248(2):95–103CrossRefPubMedGoogle Scholar
  7. 7.
    Yoon DL, Kim YJ, Koo BS, Kim YG, Lee CK, Yoo B (2014) Neuro-behçet’s disease in South Korea: clinical characteristics and treatment response. Int J Rheum Dis. doi: 10.1111/1756-185X.12265 Google Scholar
  8. 8.
    Lakhanpal S, Tani K, Lie JT, Katoh K, Ishigatsubo Y, Ohokubo T (1985) Pathologic features of Behçet’s syndrome: a review of Japanese autopsy registry data. Hum Pathol 16(8):790–795CrossRefPubMedGoogle Scholar
  9. 9.
    Jongen PJ, Daelmans HE, Bruneel B, den Hartog MR (1992) Humoral and cellular immunologic study of cerebrospinal fluid in a patient with Behçet encephalitis. Arch Neurol 49(10):1075–1078CrossRefPubMedGoogle Scholar
  10. 10.
    Bitik B, Tufan A, Sahin K, Sucullu Karadag Y, Can Sandikci S, Mercan R, Ak F, Karaaslan Y, Ozturk MA, Goker B, Haznedaroglu S (2016) The association between the parenchymal neurological involvement and posterior uveitis in Behçet’s syndrome. Clin Exp Rheumatol 34(6 Suppl 102):82–85PubMedGoogle Scholar
  11. 11.
    Cetinel B, Obek C, Solok V, Yaycioglu O, Yazici H (1988) Urologic screening for men with Behçet’s syndrome. Urology 52(5):863–865CrossRefGoogle Scholar
  12. 12.
    Siroky MB, Krane RJ (1982) Neurologic aspects of detrusor-sphincter dyssynergia, with reference to the guarding reflex. J Urol 127(5):953–957CrossRefPubMedGoogle Scholar
  13. 13.
    Cetinel B, Akpinar H, Tufek I, Uygun N, Solok V, Yazici H (1999) Bladder involvement in Behcet’s syndrome. J Urol 161:52CrossRefPubMedGoogle Scholar
  14. 14.
    Hiz O, Ediz L, Gülcü E, Tekeoglu I (2011) Effects of Behçet’s disease on sexual function and psychological status of male patients. J Sex Med 8(5):1426–1433CrossRefPubMedGoogle Scholar
  15. 15.
    Khanzada U, Khan SA, Hussain M, Adel H, Masood K, Adil SO, Manohar M (2017) Evaluation of the causes of erectile dysfunction in patients undergoing penile Doppler ultrasonography in Pakistan. World J Mens Health 35(1):22–27CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Aksu K, Keser G, Günaydin G, Ozbek SS, Colakoğlu Z, Gümüşdiş G, Doganavşargil E (2000) Erectile dysfunction in Behçet’s disease without neurological involvement: two case reports. Rheumatology (Oxford) 39(12):1429–1431CrossRefGoogle Scholar
  17. 17.
    Ait Ben Haddou EH, Imounan F, Regragui W, Mouti O, Benchakroune N, Abouqal R, Benomar A, Yahyaoui M (2012) Neurological manifestations of Behçet’s disease: evaluation of 40 patients treated by cyclophosphamide. Rev Neurol (Paris) 168(4):344–349CrossRefGoogle Scholar
  18. 18.
    Østensen M (2017) Sexual and reproductive health in rheumatic disease. Nat Rev Rheumatol 13(8):485–493CrossRefPubMedGoogle Scholar
  19. 19.
    Hatemi G, Silman A, Bang D, Bodaghi B, Chamberlain AM, Gul A, Houman MH, Kötter I, Olivieri I, Salvarani C, Sfikakis PP, Siva A, Stanford MR, Stübiger N, Yurdakul S, Yazici H, Expert Committee EULAR (2008) EULAR recommendations for the management of Behçet disease. Ann Rheum Dis 67(12):1656–1662. doi: 10.1136/ard.2007.080432 CrossRefPubMedGoogle Scholar
  20. 20.
    Zeydan B, Uygunoglu U, Saip S, Demirci ON, Seyahi E, Ugurlu S, Hamuryudan V, Siva A, Kantarci OH (2016) Infliximab is a plausible alternative for neurologic complications of Behçet disease. Neurol Neuroimmunol Neuroinflamm 3(5):e258. doi: 10.1212/NXI.0000000000000258 CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Işık M, Kılıç L, Doğan I (2013) Recurrent uveitis due to sildenafil usage in a patient with Behçet’s disease. Rheumatol Int 33(3):803CrossRefPubMedGoogle Scholar
  22. 22.
    Desbois AC, Addimanda O, Bertrand A, Deroux A, Pérard L, Depaz R, Hachulla E, Lambert M, Launay D, Subran B, Ackerman F, Mariette X, Cohen F, Marie I, Salvarini C, Cacoub P, Saadoun D (2016) Efficacy of Anti-TNFα in severe and refractory neuro-behcet disease: an observational study. Medicine (Baltimore) 95(23):e3550. doi: 10.1097/MD.0000000000003550 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Tepecik Teaching and Research Hospital, Rheumatology SectionSBUIzmirTurkey
  2. 2.Medical Faculty, Department of RheumatologyDokuz Eylul UniversityIzmirTurkey

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