Predictive Factors of Male Sexual Dysfunction After Traumatic Spinal Cord Injury

Spine (Phila Pa 1976). 2019 Sep 1;44(17):1228-1237. doi: 10.1097/BRS.0000000000003049.

Abstract

Study design: Observational study (Ethics Committee Number 973.648).

Objective: Evaluating the social and clinical factors associated with sexual dysfunction in men with traumatic spinal cord injury, as well as predictive factors for sexual dysfunction.

Summary of background data: Besides the motor and sensory loss, sexual function changes after spinal cord injury, ranging from decreased sexual desire to erectile disorders, orgasm, and ejaculation.

Methods: Performed with 45 men, with traumatic spinal cord injury and sexually active. Sexual function was assessed by the International Index of Erectile Function and the level and degree of injury were determined following guidelines of International Standards for Neurological and Functional Examination Classification of Spinal Cord Injury. Bi and multivariate analysis was applied, with a 0.05 significance level.

Results: Forty-five subjects with mean injury time of 7.5 years (CI 5.2-9.9) were evaluated. Having a fixed partner is a protective factor (OR: 0.25; 95% CI: 0.07-0.92) of erectile dysfunction. Sexual desire is associated with the fixed partner (OR: 0.12; 95% CI: 0.02-0.66), masturbation (OR: 0.13; 95% CI: 0.02-0.62), and sexual intercourse in the last month (OR: 0.13; 95% IC: 0.01-0.92). Ejaculation (OR: 0.01; 95% CI: 0.00-0.15) and erectile dysfunction (OR: 15.7; 95% CI: 1.38-178.58) are associated with orgasm. Psychogenic erection (OR: 0.07; 95% CI: 0.01-0.69), monthly frequency of sexual intercourse (OR: 11.3; 95% CI: 2.0-62.8), and orgasmic dysfunction (OR: 7.1; 95% CI: 1.1-44.8) are associated with satisfaction.

Conclusion: Fixed partner, ejaculation, masturbation are protective factors for sexual dysfunction. Erectile dysfunction, orgasmic, and infrequent sex dysfunction are predictors of sexual dysfunction.

Level of evidence: 3.

MeSH terms

  • Humans
  • Male
  • Risk Factors
  • Sexual Dysfunction, Physiological* / epidemiology
  • Sexual Dysfunction, Physiological* / etiology
  • Sexual Dysfunctions, Psychological* / epidemiology
  • Sexual Dysfunctions, Psychological* / etiology
  • Spinal Cord Injuries* / complications
  • Spinal Cord Injuries* / epidemiology