A Primary Care Provider’s Guide to Clinical Needs of Women With Spinal Cord Injury

Slocum, Chloe; Halloran, Molly B.; Unser, Cody

doi:10.46292/sci2603-166

Cited by 4 publications

(3 citation statements)

References 30 publications

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“…More than 70% of men with SCI report ejaculatory dysfunction in addition to erectile dysfunction, and require medical assistance to ejaculate [46]. SCI has been associated with diminished sexual desire, impaired lubrication, and changes in orgasm for women with SCI as well as changes to erogenous zones [47]. SCI above the level of T6 is associated with a greater risk for autonomic dysreflexia during sexual activity, particularly during genital stimulation, use of a vibrator, and when achieving an orgasm.…”

Section: Sexual Dysfunctionmentioning

confidence: 99%

Urogenital dysfunction following neurotrauma

Saraf

Panicker

2022

Current Opinion in Neurology

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Purpose of reviewTrauma affecting the nervous system can have widespread consequences, depending on the location and severity of injury. The sensorimotor and cognitive deficits due to neurotrauma have been studied extensively. Although the overall mortality due to neurotrauma has reduced, the disability and morbidity due to neurotrauma has not significantly reduced and focus on urogenital disturbances in these patients has been limited. This article reviews the limited evidence and scientific literature on this topic. Recent findingsLower urinary tract symptoms are commonly reported in patients with neurotrauma, both acutely and over the long term. Multiple medical and surgical approaches are available for managing bladder dysfunction in these patients. Sexual dysfunction and changes in sexual behaviour are reported by patients with neurotrauma and are usually multifactorial. Treatment options for sexual dysfunction are available and their management requires a holistic approach. SummaryUrogenital dysfunction contributes significantly to the overall functional outcome and impaired quality of life in patients with neurotrauma. A better understanding of the mechanisms behind the urogenital abnormalities is needed for efficient management and treatment.

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Section: Sexual Dysfunctionmentioning

confidence: 99%

Urogenital dysfunction following neurotrauma

Saraf

Panicker

2022

Current Opinion in Neurology

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“…About 80% of SCIs in Spain occur in the age range of 16-45 years [3]. Although SCI is less frequent in women (20%) [4], it is worth highlighting that, in the last years, the percentage of women with SCI has increased [5] and that 88% of these women experience sexual dysfunction (SD). This percentage, compared to the one found in the general female population (37%), is significantly higher [6], with its consequent impact at the personal and social level, and thus on the quality of life.…”

Section: Introductionmentioning

confidence: 99%

Vibration or Transcutaneous Tibial Nerve Stimulation as a Treatment for Sexual Dysfunction in Women with Spinal Cord Injury: Study Protocol for a Randomized Clinical Trial

Díaz-Ruiz

Romero-Galisteo

Arranz-Martín

et al. 2022

IJERPH

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Background: Women with spinal cord injuries usually suffer from sexual dysfunction, such as alterations during arousal and an increase in the time to reach orgasm. However, little evidence has been found on its physiotherapeutic approach, as well as poor adherence to the latter. The aim of this study is to determine the effectiveness of two interventions to improve sexual dysfunction: the application of genital vibration and transcutaneous tibial nerve stimulation. Methods: This is a randomized clinical trial that will recruit 54 women who, one year after a spinal cord injury, suffer from sexual dysfunction associated with the latter. The participants will be randomized to three groups: (a) intervention group 1 treated with transcutaneous tibial nerve electrostimulation (n = 18), (b) intervention group 2 treated with genital vibration (n = 18), and (c) a control group (n = 18). The treatment time will be 12 weeks. Adherence to the treatment will be evaluated, as well as the effectiveness of the treatment, through the Female Sexual Function Index, the Sexual Quality of Life-Female questionnaire, quantitative sensory tests, and the improvement reported by the patient in terms of arousal and orgasm. The evaluations will be carried out before the treatment, at the end of the treatment and 3, 6 and 12 months after the end of the treatment.

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“…In elderly populations, some of the dominant causes of SCI include low-level falls leading to traumatic SCI (TSCI) [ 1 , 3 , 4 ], and degenerative processes and diseases leading to non-traumatic SCI (NTSCI) [ 2 , 3 ]. Although gender-specific considerations should be incorporated into most aspects of SCI management [ 5 ], they may particularly concern the urological domain, given the substantial physiological and anatomical differences in the lower urinary tract (LUT) between sexes [ 6 ]. Indeed, the neuro-urology guidelines do make female-specific recommendations in the cases where relevant evidence is present [ 7 ], but to this point, much of the urological research in SCI has been conducted in predominantly male populations [ 8 ], that are also often small and heterogeneous [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Sex differences in urological management during spinal cord injury rehabilitation: results from a prospective multicenter longitudinal cohort study

et al. 2022

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Study Design Prospective, multicenter, longitudinal cohort study. Objectives To describe female-male differences in first-line urological management during spinal cord injury (SCI) rehabilitation. Setting Inpatient specialized post-acute SCI rehabilitation in Switzerland. Methods Data on bladder storage medication (antimuscarinic and beta-3 agonist) use, suprapubic catheter placement, demographic and SCI characteristics was collected within 40 days of SCI and at rehabilitation discharge from May 2013-September 2021. Prevalence and indicators of bladder storage medication and suprapubic catheter use at discharge were investigated with sex-stratified descriptive and logistic regression analyses. Results In 748 patients (219 females, 29%), bladder storage medication use at discharge had a prevalence of 24% (95% CI: 18-29%) for females and 30% (95% CI: 26-34%) for males and was indicated by cervical AIS grade A,B,C and traumatic SCI in both sexes. Thoracic AIS grade A,B,C SCI (males), and lumbar/sacral AIS grade A,B,C SCI (females) predicted higher odds of bladder storage medication use (SCI characteristic*sex interaction, p <0.01). Prevalence of suprapubic catheter use at discharge was 22% (95% CI: 17-28%) for females and 17% (95% CI: 14-20%) for males. Suprapubic catheter use was indicated by cervical AIS grade A,B,C SCI, and age >60 in both sexes. Females with thoracic grade A,B,C SCI tended to have higher odds of suprapubic catheter use (SCI characteristic*sex interaction, p =0.013). Conclusions We identified sex differences in urological management especially in persons with AIS grade C or higher sub-cervical SCI. There is scope for well-powered, female-specific research in SCI in order to understand the underlying mechanisms and support patient-tailored management.

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A Primary Care Provider’s Guide to Clinical Needs of Women With Spinal Cord Injury

Cited by 4 publications

References 30 publications

Urogenital dysfunction following neurotrauma

Urogenital dysfunction following neurotrauma

Vibration or Transcutaneous Tibial Nerve Stimulation as a Treatment for Sexual Dysfunction in Women with Spinal Cord Injury: Study Protocol for a Randomized Clinical Trial

Sex differences in urological management during spinal cord injury rehabilitation: results from a prospective multicenter longitudinal cohort study

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