Sexual health after spinal cord injury: A longitudinal study

Fisher, T. L.; Laud, Prakash; Byfield, Margaret G.; Brown, Traci T.; Hayat, Matthew J.; Fiedler, Irma G.

doi:10.1053/apmr.2002.33654

Cited by 101 publications

(95 citation statements)

References 13 publications

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“…7 Health-care providers deem sex life significant in the process of rehabilitation after SCI and give high priority to improving sexual activity for subjects with SCI. 8,9 Nitric oxide (NO) released by nonadrenergic-noncholinergic nerves in the penis has an important role in initiating and maintaining of the penile erection process. 10,11 NO diffuses to smooth where it augments the formation of cyclic guanosine monophosphate, which acts as a second messenger for engorgement of penile vasculature and penile erection.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and safety of phosphodieterase-5 inhibitors for treatment of erectile dysfunction secondary to spinal cord injury: a systemic review and meta-analysis

Cheng

et al. 2016

Spinal Cord

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Objective: We carried out a systematic review and meta-analysis to assess the efficacy and safety of phosphodieterase-5 (PDE5) inhibitors on erectile dysfunction (ED) secondary to spinal cord injury (SCI). Methods: A literature review was performed to identify all published randomized, double-blind, placebo-controlled trials of PDE5 inhibitors for treatment of ED secondary to SCI. The search included the following database: MEDLINE, EMBASE and the Cochrane Library. The outcomes and complications analyzed involved the Global Efficacy Question (GEQ), sexual encounter profile diary question 2 and 3 (SEP2 and SEP3) and adverse events. All statistical analysis was performed using Stata 12.0 software (Stata Corp., College Station, TX, USA). Results: Six publications were used in analysis, including six randomized controlled trials that compared PDE5 inhibitors with placebo. Compared with placebo, PDE5 inhibitors were associated with significant improvements in GEQ (OR 11.997, 95% CI 8.073-17.830, Po0.0001), SEP2 (RR 1.847, 95% CI 1.561-2.185, Po0.0001) and SEP3 (RR 2.738, 95% CI 2.084-3.598, Po0.0001). Despite significant greater incidences of some adverse events observed (headache: RR 3.717, 95% CI 2.309-5.982, Po0.0001; flushing: RR 9.281, 95% CI 2.858-30.147, Po0.0001; gastrointestinal discomfort: RR 9.064, 95% CI 2.116-38.827, P = 0.003), most adverse events were mild to moderate and transient. Conclusions: This systematic review and meta-analysis indicate that PDE5 inhibitors are effective and well tolerated to treat ED secondary to SCI compared with placebo, as measured by response to GEQ, SEP2, SEP3 and incidence of adverse events. PDE5 inhibitors could be considered as the first choice in the treatment of ED patients with SCI. INTRODUCTIONApproximately 11 000 new cases are estimated to suffer from spinal cord injury (SCI) in America each year and 60% of them are between 16 and 30 years of age. Moreover, men account for 82% of all patients with SCI. 1,2 Erectile dysfunction (ED) is a common condition in individuals with SCI. 3 A high prevalence of ED is reported in about 80% of SCI patients. 4 It is an especially bothersome condition in young men who usually had an active sexual activity before their accident. 5 ED is defined as the persistent inability to achieve or maintain a penile erection for satisfactory sexual performance. 6 Most men with SCI have some type of penile erection, but it is usually not hard enough or does not last long enough for sexual life. 1 ED not only often results in disorder of self-esteem but also deteriorates partner relationship. Hence, ED has a negative effect on the life of men and their sexual partner. 7 Health-care providers deem sex life significant in the process of rehabilitation after SCI and give high priority to improving sexual activity for subjects with SCI. 8,9 Nitric oxide (NO) released by nonadrenergic-noncholinergic nerves in the penis has an important role in initiating and maintaining of the

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Efficacy and safety of phosphodieterase-5 inhibitors for treatment of erectile dysfunction secondary to spinal cord injury: a systemic review and meta-analysis

Cheng

et al. 2016

Spinal Cord

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“…Yapılan çalışmalarda SKY'li hastalarda orgazm, yaralanma öncesi ve sağlam kontrol grubuna göre anlamlı düzeyde düşük bulunmuştur (16,17). Reitz ve ark.…”

Section: Discussionunclassified

Sexual Functions in Male Patients with Traumatic Spinal Cord Injury

Güzelküçük¹,

Yılmaz²,

Yavuz³

et al. 2014

Turk J Phys Med Rehab

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Objective: To explore sexual dysfunctions and expectations about sexuality in male patients with spinal cord injury (SCI) aged between 20-40. Material and Methods: A total of 75 traumatic SCI male patients were included in this study. The demographic and clinical characteristics were obtained by retrospective chart review. The differences between preinjury and post-injury sexuality status of the participants were assessed. The relationship between neurological level and erection/ejaculation was investigated. Results: The mean age of the participants was 26.16±4.35 years. The mean time since injury was 34.26±30.68 months. The number of the patients who had sexual interactions before injury was 63 (84%). Also, 34 patients (45%) had sex after injury, but 66 (88%) of the patients mentioned that their sexuality was affected after injury; 31 (41.3%) of the patients were not informed about sexuality in the post-injury period. Further, erection duration of 37 (60.6%) of the participants was shorter than 5 minutes, and 20 (32.8%) of the patients reported that they were satisfied with their erection. Moreover, 31 (41.3%) of the patients had reflex erection (RE), 14 (18.7%) of them had a psychogenic erection (PE), 16 (21.3%) of them got a mixed type of erection (RE+PE), and 14 (18.7%) of the patients did not have an erection. Ejaculation was present in 28 (37.3%) of the patients. The first three responses to questions about circumstances causing problems in post-injury sexual life and expectations for sexual life were erection, ejaculation, and orgasm, respectively. Conclusion: This study showed that sexual functions, like erection, ejaculation, and orgasm, in male patients were affected severely after SCI. The majority of the patients did not have enough sexual consulting, and the patients had great expectations for getting informed about sexuality in the post-injury period. Key Words: Spinal cord injury, sexuality, sexual dysfunction, rehabilitation Özet Amaç: Spinal kord yaralanması (SKY) olan 20-40 yaş arası erkek hastalarda seksüel fonksiyon bozukluklarının ve hastaların seksüalite konusunda beklentilerinin ortaya konulması. Gereç ve Yöntemler: Çalışmaya 75 travmatik SKY'li erkek hasta dahil edildi. Hastaların tıbbi kayıtlarından seksüel rehabilitasyon takip dosyası elde edildi. Bu takip dosyası ile hastaların demografik ve klinik verileri ile yaralanma öncesi ve sonrası seksüel yaşamı tespit edildi. Nörolojik seviyelerin ereksiyon ve ejakülasyon ile olan ilişkileri araştırıldı. Bulgular: Hastalarımızın yaş ortalaması 26,16±4,35, yaralanma sonrası geçen süre 34,26±30,68 ay idi. Yaralanma öncesi seksüel ilişkiye giren hasta sayısı 63 (%84), yaralanma sonrası 34 (%45) idi. Altmış altı (%88) hasta yaralanma sonrası seksüel yaşamının etkilendiğini ifade etti. Otuz bir (%41,3) hasta seksüalite konusunda herhangi bir bilgi almamıştı. Ereksiyon süresi 37 (%60,6) hastada 5 dakika ve altındaydı. Yirmi (%32,8) hasta ereksiyonun yeterli olduğunu ifade etmiştir. Otuz bir (%41,3) hastada refleks ereksiyon (RE), 14 (%18,7) ...

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“…Spinal kord yaralanmalı bireylerde seksüel eğitim ve danışma için, taburculuktan sonraki ilk altı ay dönüm noktası olarak bulunmuştur (21). Literatürlerle uyumlu olarak bizim çalışmamızda da hastaların büyük çoğunluğu (%54'ü), taburculuktan sonraki ilk 6 ay içinde cinsellikle ilgili soruların kafalarında oluştuğunu belirttiler.…”

Section: Discussionunclassified

Sexual Function in Female Patients with Spinal Cord Injury

Civici¹,

Yılmaz²,

Güzelküçük³

et al. 2014

Turk J Phys Med Rehab

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Objective: To determine the perception of sexuality, sexual function disorders and the effects of quality of life of sexual problems in female patients with spinal cord injury (SCI) in a Turkish population. Material and Methods: This study group was between the ages of 18-58 years; female SCI patients, sexually active before the spinal cord injury, were included. The control group consisted of healthy women. Neurological levels T10 and above, T11-L2, conus, and cauda were classified in three sub-groups. SCI and healthy women were evaluated with the TAF Rehabilitation Center Sexual Rehabilitation Evaluation Form in Women with SCI, Female Sexual Function Index, and Satisfaction With Life Scale. Results: Fifty SCI and 50 healthy women were included into the study; 46 patients before the injury and 40 patients after the injury had sexual intercourse experience, respectively. The decrease in sexual arousal and sexual intercourse was statistically significant (p=0.000) in the after-injury group than before the injury. Sexual interest and importance given to sexuality were significantly lower before the injury than in the control group (p<0.05). After SCI, based on the need to share intimacy, sexual activity ratio was 84%. In patients with a sense of the genitals, level of arousal was greater than those without (p=0.002). Lack of orgasm and sexual desire after the injury was the major problem experienced in sexual intercourse and was significantly increased after the SCI (p<0.05). Conslusion: In this study, we found that female SCI patients have a significant deterioration in sexual function, and it also impairs quality of life. Yaralanma öncesine göre, yaralanma sonrası cinsel uyarılma ve seksüel ilişkiye girme sıklığındaki azalma istatistiksel olarak anlamlı idi (p=0,000). Spinal kord yaralanmalı kadınlarda seksüel ilgi ve seksüaliteye verilen önem, yaralanma öncesine ve sağlam kontrol grubuna göre anlamlı oranda düşük bulundu (p<0,05). Spinal kord yaralanma sonrası, seksüel aktivite %84 oranında samimiyet ve paylaşma ihtiyacı tabanlı idi. Genital bölge duyusu olan hastalarda, olmayanlara göre uyarılma daha iyi düzeylerde idi (p=0,002). Yaralanma sonrası orgazm olamama ve seksüel istek azlığı ön planda olmak üzere, seksüel ilişkide yaşanan problemlerde istatistiksel olarak anlamlı bir artış saptandı (p<0,05). Sonuç: Bu çalışmada, SKY'li kadınlarda önemli derecede seksüel fonksiyonlarda bozulma olduğunu ve bunun da yaşam kalitesini bozduğunu bulduk. Anahtar Kelimeler: Seksüalite, seksüel fonksiyon bozukluğu, spinal kord yaralanması, rehabilitasyon

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Sexual health after spinal cord injury: A longitudinal study

Cited by 101 publications

References 13 publications

Efficacy and safety of phosphodieterase-5 inhibitors for treatment of erectile dysfunction secondary to spinal cord injury: a systemic review and meta-analysis

Efficacy and safety of phosphodieterase-5 inhibitors for treatment of erectile dysfunction secondary to spinal cord injury: a systemic review and meta-analysis

Sexual Functions in Male Patients with Traumatic Spinal Cord Injury

Sexual Function in Female Patients with Spinal Cord Injury

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