Evaluation of Sexual Dysfunction in Men With Spinal Cord Injury Using the Male Sexual Quotient

Miranda, Eduardo; Gomes, Cristiano Mendes; Bessa, José de; Abdo, Carmita Helena Najjar; Bellucci, Carlos Henrique Suzuki; Filho, Jose Everton de Castro; Carvalho, Fabrício Leite; Souza, Daniel Rubio de; Battistella, Linamara Rizzo; Scazufca, Márcia; Bruschini, Homero; Filho, Tarcisio Barros; Srougi, Miguel

doi:10.1016/j.apmr.2016.01.005

Cited by 20 publications

(15 citation statements)

References 32 publications

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“…The baseline sexual desire values obtained for the research participants in the present study were consistent with surveys that have documented high levels of sexual interest, particularly in comparison to other domains such as satisfaction [ 118 , 119 ]. These findings underscore the need for continuous intervention by health professionals for guidance on treating sexual dysfunction in the SCI population.…”

Section: Discussionsupporting

confidence: 87%

Improvements in bladder, bowel and sexual outcomes following task-specific locomotor training in human spinal cord injury

et al. 2018

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ObjectiveLocomotor training (LT) as a therapeutic intervention following spinal cord injury (SCI) is an effective rehabilitation strategy for improving motor outcomes, but its impact on non-locomotor functions is unknown. Given recent results of our labs’ pre-clinical animal SCI LT studies and existing overlap of lumbosacral spinal circuitries controlling pelvic-visceral and locomotor functions, we addressed whether LT can improve bladder, bowel and sexual function in humans at chronic SCI time-points (> two years post-injury).Study designProspective cohort study; pilot trial with small sample size.MethodsEight SCI research participants who were undergoing 80 daily one-hour sessions of LT on a treadmill using body-weight support, or one-hour of LT and stand training on alternate days, as part of another research study conducted at the Kentucky Spinal Cord Injury Research Center, University of Louisville, were enrolled in this pilot trial. Urodynamic assessments were performed and International Data Set questionnaire forms completed for bladder, bowel and sexual functions at pre-and post-training time points. Four usual care (non-trained; regular at-home routine) research participants were also enrolled in this study and had the same assessments collected twice, at least 3 months apart.ResultsFilling cystometry documented significant increases in bladder capacity, voiding efficiency and detrusor contraction time as well as significant decreases in voiding pressure post-training relative to baseline. Questionnaires revealed a decrease in the frequency of nocturia and urinary incontinence for several research participants as well as a significant decrease in time required for defecation and a significant increase in sexual desire post-training. No significant differences were found for usual care research participants.ConclusionsThese results suggest that an appropriate level of sensory information provided to the spinal cord, generated through task-specific stepping and/or loading, can positively benefit the neural circuitries controlling urogenital and bowel functions.Trial registrationClinicalTrials.gov NCT03036527

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Section: Discussionsupporting

confidence: 87%

Improvements in bladder, bowel and sexual outcomes following task-specific locomotor training in human spinal cord injury

et al. 2018

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“…We were unable to measure serum prolactin levels in our study participants to determine whether hyperprolactinemia may have been associated with central suppression of the HPT axis in men with SCI. In addition, we cannot discount that other factors, such as interruption of afferent sensory sexual inputs or lack of sexual activity, may have contributed to low T in young men with SCI with evidence of primary hypogonadism [7]; however, given the design of our study, we were unable to assess sexual function.…”

Section: Discussionmentioning

confidence: 95%

“…Indeed, hypogonadism is important to consider in men with SCI because testosterone (T) deficiency may further accelerate the aging process and ultimately may contribute to increased cardiometabolic risk by promoting the development of sarcopenic obesity, hyperinsulinemia, dyslipidemia, and a heightened inflammatory state, as has been demonstrated in noninjured hypogonadal individuals [5,6]. Furthermore, androgen deficiency in men with SCI may contribute to sexual dysfunction and infertility, which are common after injury [7].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Etiology of Hypogonadism in Young Men With Chronic Spinal Cord Injury: A Cross‐Sectional Analysis From Two University‐Based Rehabilitation Centers

Sullivan

Nash

Tefera

et al. 2016

PM&R

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Background Spinal cord injury (SCI) triggers an ‘accelerated aging’ process that may include development of hypogonadism, even among younger men with SCI; however, few studies have investigated the prevalence or etiology of hypogonadism in men with SCI. Young men with SCI are also at increased risk for developing metabolic dysfunction after injury, which may be exacerbated by concomitant testosterone (T) deficiency, thus identifying the prevalence and risk factors for T deficiency in men with SCI is important for their long-term health. Objective To investigate the prevalence, risk factors, and etiology of T deficiency (hypogonadism) in otherwise healthy men with chronic, motor complete SCI. Design Secondary cross-sectional analysis. Setting Rehabilitation research centers in Washington, DC, and Miami, Florida, USA. Participants Men (n=58) aged 18-45 with chronic (≥1 year), motor complete SCI without co-morbidities or use of testosterone therapy. Methods Plasma concentrations of hormones were measured using standardized assays. Body composition was assessed with DXA scan. Main Outcome Measurements Serum total testosterone and calculated free T. Results T deficiency was more common in men after SCI than in a matched cohort of similarly-aged men without SCI (25%, SCI vs 6.7%, non-SCI, P<.001). The risk of hypogonadism appeared to be increased in men with more extensive injury and with higher percent body fat. The majority of men with SCI with low T had low serum LH levels, suggesting that central suppression of the hypothalamic-pituitary-gonadal axis may be the most common etiology of hypogonadism after SCI. Conclusions Hypogonadism is more common in young men with SCI than in similarly-aged men without SCI, suggesting that SCI should be identified as a risk factor for T deficiency and that routine screening for hypogonadism should be performed in the SCI population.

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“…6 In men, following traumatic SCI, erectile function, ejaculation and orgasm are most severely affected, while sexual desire remains high. 7 Personal interviews with 33 heterosexual men with chronic SCI demonstrated that a willingness to adapt their sexual behavior, coupled with the reward of physical pleasure experienced during intercourse, can result in a positive and satisfying sex life. 8 High-quality SCI rehabilitation training programs for patients should address expectations for sexual activity and sexual satisfaction within their core curriculum.…”

Section: Introductionmentioning

confidence: 99%

Conception and development of Sexual Health indicators to advance the quality of spinal cord injury rehabilitation: SCI-High Project

Elliott

Jeyathevan

Hocaloski

et al. 2019

The Journal of Spinal Cord Medicine

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Context: Although spinal cord injury or disease (SCI/D) results in complex biological and psychosocial impairments that adversely impact an individual's overall quality of sexual life, sexual health is poorly integrated into the current rehabilitation processes. Therefore, it is vital to promote sexual health as a rehabilitation priority. Herein, we describe the selection of Sexual Health structure, process and outcome indicators for adults with SCI/D in the first 18 months after rehabilitation admission. Methods: Experts in sexual health and the SCI-High team identified key factors that influence the sexual health outcomes of rehabilitation interventions to inform Driver diagram development. This diagram informed the selection and development of indicators to promote a permissive environment for discussion of sexual health issues among regulated health care professionals (HCPs). A review of literature and psychometric properties of measurement tools facilitated final indicators selection. Results: The structure indicator is the proportion of rehabilitation HCPs who have completed annual preliminary sexual health training. The process indicator is the proportion of SCI/D inpatients that have a documented introduction to available local sexual health resources. The outcome indicator is a sexual health patient questionnaire used to assess sexual health patient outcomes and sexual health information/educational needs. Rapid-cycle piloting verified that the indicator tools developed are feasible for implementation. Conclusion: Successful implementation of the Sexual Health structure, process and outcome indicators will promote a permissive environment to enable open discussion, and lead to provision of equitable and optimal care related to sexual health following SCI/D. This will ultimately advance sexual health rehabilitation across the nation.

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Evaluation of Sexual Dysfunction in Men With Spinal Cord Injury Using the Male Sexual Quotient

Cited by 20 publications

References 32 publications

Improvements in bladder, bowel and sexual outcomes following task-specific locomotor training in human spinal cord injury

Improvements in bladder, bowel and sexual outcomes following task-specific locomotor training in human spinal cord injury

Prevalence and Etiology of Hypogonadism in Young Men With Chronic Spinal Cord Injury: A Cross‐Sectional Analysis From Two University‐Based Rehabilitation Centers

Conception and development of Sexual Health indicators to advance the quality of spinal cord injury rehabilitation: SCI-High Project

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