Neurogenic Sexual Dysfunction in Spinal Cord Injured – Retrospective Study
DOI:
https://doi.org/10.25759/spmfr.109Abstract
Background: Spinal cord injury is an important cause of disability, with many physical and psycho-social repercussions. Sexuality in patients with Spinal Cord Injury (SCI) is frequently compromised, determining low levels of satisfaction with it. There are several therapeutic options available nowadays, that can be associated to other interventions, such as psychological and behavioural counseling, pharmacological therapy, penile vibratory stimulation, among others. Despite this fact, it remains as an area least addressed in the long-term SCI patient rehabilitation, with unquestionable repercussions in the individual/couple physical and mental well-being and social and family integration.
Objective: Characterize demographic and clinically the population of SCI paraplegic patients followed in a Neurogenic Sexual Dysfunction Consultation, identifying the most common therapeutic interventions done.
Methods and Subjects: Retrospective longitudinal study of paraplegic patients followed in a Neurogenic Sexual Dysfunction Consultation, between 2005 and 2008. Socio-demographical, clinical and therapeutic intervention data were collected from clinical files.
Results: A total of 178 paraplegic patients were followed in a Neurogenic Sexual Dysfunction Consultation between 2005 April and 2008 December, aged between 18 e 81 years-old and of male gender in the majority. Traumatic etiology was the main cause of SCI, with similar number of complete and incomplete lesions. 48% of patients had neurological levels above D10 and 37% between D10 and L2. 87,7% of the male patients with complete lesions had some type of erection (reflexogenic, psychogenic or both); in incomplete lesions, erection was present in 94,6% .
Only 28 % of the males had antegrade ejaculation. Of the non-ejaculating patients, 28 (18%) were submitted to treatment with penile vibratory stimulation, with positive result (antegrade ejaculation) in 43% of those cases.
Phosphodiesterase type-5 inhibitors were the commonest therapeutic used in male patients and vaginal lubricant in women.
Psychological intervention was provided to 37,6% of patients.
Conclusions: SCI impact on sexuality is significant, determining a change on the way the individual and the couple live it. Clinical intervention of Sexual Reeducation allows the patient guidance to a sexuality rediscovery and to make it more satisfying, through the available therapeutic resources, contributing strongly to the psycho-social well-being of the disabled patient.
Keywords: Sexual Dysfunction, Physiological; Paraplegia
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