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Predictive Factors of Male Sexual Dysfunction After Traumatic Spinal Cord Injury

Ferro, Josepha Karinne de Oliveira MD; Lemos, Andrea PhD; Silva, Caroline Palácio da BS; Lima, Claudia Regina Oliveira de Paiva PhD; Raposo, Maria Cristina Falcão PhD; Cavalcanti, Geraldo de Aguiar PhD‡,§; Oliveira, Daniella Araújo de PhD

doi: 10.1097/BRS.0000000000003049
HEALTH SERVICES RESEARCH
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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

Sociodemographic and clinical data are predictive factors for sexual dysfunction in men with spinal cord injury. Fixed partner, ejaculation, masturbation are protective factors for sexual dysfunction while erectile dysfunction, orgasmic, and infrequent sex dysfunction are predictors of sexual dysfunction.

Department of Physical Therapy, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil

Department of Statistics, Federal University of Pernambuco, Recife, Pernambuco, Brazil

Division of Urology, Federal University of Pernambuco, Recife, Pernambuco, Brazil

§Urology Center, Institute of Integral Medicine Professor Fernando Figueira, Recife, Pernambuco, Brazil.

Address correspondence and reprint requests to Josepha Karinne de Oliveira Ferro, MD, Rua Amália Bernardino de Souza, 264, 1601 – Boa Viagem, Recife - PE, 51021-150, Brazil; E-mail: karinneferro@gmail.com

Received 9 October, 2018

Revised 23 January, 2019

Accepted 5 March, 2019

The manuscript submitted does not contain information about medical device(s)/drug(s).

No relevant financial activities outside the submitted work.

No funds were received in support of this work.

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