A study on sexual function in 56 male patients with complete irreversible lesions of the spinal cord and cauda equina

Jochheim, Kurt-Alphons; Wahle, H

doi:10.1038/sc.1970.30

Cited by 16 publications

(3 citation statements)

References 4 publications

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“…Clinical observations (Jochheim and Wahle, 1970) indicate that pathways exist between the brain or brainstem and thoracolumbar and/or sacral spinal cord that control sexual performance, including ejaculation, because urogenital function is severely impaired in patients with spinal cord injuries. The importance of these pathways is also emphasized by the fact that the main complaint of these patients is the inability to maintain a normal sex life rather than the inability to walk (Comarr, 1971).…”

Section: Discussionmentioning

confidence: 99%

Brain Activation during Human Male Ejaculation

et al. 2003

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Brain mechanisms that control human sexual behavior in general, and ejaculation in particular, are poorly understood. We used positron emission tomography to measure increases in regional cerebral blood flow (rCBF) during ejaculation compared with sexual stimulation in heterosexual male volunteers. Manual penile stimulation was performed by the volunteer's female partner. Primary activation was found in the mesodiencephalic transition zone, including the ventral tegmental area, which is involved in a wide variety of rewarding behaviors. Parallels are drawn between ejaculation and heroin rush. Other activated mesodiencephalic structures are the midbrain lateral central tegmental field, zona incerta, subparafascicular nucleus, and the ventroposterior, midline, and intralaminar thalamic nuclei. Increased activation was also present in the lateral putamen and adjoining parts of the claustrum. Neocortical activity was only found in Brodmann areas 7/40, 18, 21, 23, and 47, exclusively on the right side. On the basis of studies in rodents, the medial preoptic area, bed nucleus of the stria terminalis, and amygdala are thought to be involved in ejaculation, but increased rCBF was not found in any of these regions. Conversely, in the amygdala and adjacent entorhinal cortex, a decrease in activation was observed. Remarkably strong rCBF increases were observed in the cerebellum. These findings corroborate the recent notion that the cerebellum plays an important role in emotional processing. The present study for the first time provides insight into which regions in the human brain play a primary role in ejaculation, and the results might have important implications for our understanding of how human ejaculation is brought about, and for our ability to improve sexual function and satisfaction in men.

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Section: Discussionmentioning

confidence: 99%

Brain Activation during Human Male Ejaculation

et al. 2003

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“…Since World War II, numerous studies were published concerning the impact of spinal cord injury on sexual health [1][2][3][4][5][6][7][8]. Recently, a study was published about the association between low back pain and sexual dysfunction (SD) [9].…”

Section: Introductionmentioning

confidence: 99%

Discussing sexual health in spinal care

et al. 2015

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Background The possible detrimental effects of spinal disease on sexual health are widely recognized; however, it is not known to what extent neurosurgeons discuss this topic with their patients. The aim of this study is to identify knowledge, attitude and practice patterns of neurosurgeons counseling their patients about sexual health. Methods All members of the Dutch Association of Neurosurgery (neurosurgeons and residents) were sent a questionnaire addressing their attitudes, knowledge and practice patterns regarding discussing sexual health. Results Response rate was 62 % with 89 questionnaires suitable for analysis. The majority of participants (83 %) were male; mean age, 42.4 years. The mean experience in neurosurgical practice was 9 years. Respondents assumed that in 34 % of their patients, sexual health was affected due to spinal disease. The majority of respondents (64 %) stated that responsibility for discussing sexual health lies (partly) with the neurosurgeon; however, 73 % indicated to (almost) never do this. The main reasons for not discussing sexual health were patients' old age (42 %), lack of knowledge (38 %) and lack of patients' initiative to bring up the subject (36 %). Twenty-six percent indicated lack of time as a reason. There was no evidence for gender or doctor's age discordance as important barriers. Fifty percent of participants wished to gain more knowledge on discussing sexual health with patients. Conclusion This study shows that despite high prevalence of sexual dysfunction (SD) in spinal patients, counseling about sexual health is not often done in neurosurgical care. More training on sexual health counseling early in the residency program seems critical. By initiating the discussion, clinicians who deal with spinal patients have the potential to detect sexual dysfunction (SD) and to refer adequately when necessary, thereby improving overall quality of life of their patients.

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“…The popular assumption that sexual functioning is a physical impossibility for any male with a spinal cord lesion has been shown by many clinical and research investigations to be clearly untrue.2, 3,4,7,8,9,17,19,24,25,30,34,35 A composite survey of 9 studies in reference to the sexual functioning of SCI males which included more than 2,250 subjects (Griffith 1973) demonstrated a great variability of physical potential depending upon the site and completeness of the lesion; as many as 54-87% of all subjects could achieve erection, 5-50% intercourse, 3-20% ejaculation, 2-14% orgasm and 0-5% fertility. Erection and intercourse were most attainable in cases of upper motor neuron lesions, while ejaculation, orgasm and fertility were more probable in lower motor neuron lesions.…”

Section: Literature Reviewmentioning

confidence: 99%

Sexual Counselling for Spinal Cord Injured Males

Krelenbaum

Love

1979

Can J Occup Ther

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This paper describes some of the physical and psychological aspects of sexual adjustment in spinal cord injured males as has been documented in current literature. The authors then present the findings of a research study which they conducted. This study investigates attitudes toward sexuality and sexual functioning among a sample of spinal cord injured men, and explores the kind of professional medical services these men availed themselves of and would find desirable in dealing with this aspect of their rehabilitation. From this information the authors attempt to determine to what extent there is a need for qualified sexual counselling for spinal cord injured males and in what manner it might be most effectively offered.

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A study on sexual function in 56 male patients with complete irreversible lesions of the spinal cord and cauda equina

Cited by 16 publications

References 4 publications

Brain Activation during Human Male Ejaculation

Brain Activation during Human Male Ejaculation

Discussing sexual health in spinal care

Sexual Counselling for Spinal Cord Injured Males

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