Predictors of Successful Sexual Partnering of Adults With Spina Bifida

Gatti, Claudia; Rossi, Carmine Del; Ferrari, Adriano; Casolari, E.; Casadio, Giovanni; Scirè, G.

doi:10.1016/j.juro.2009.02.065

Cited by 56 publications

(46 citation statements)

References 20 publications

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“…The response rate of 74% is regarded as good, compared with similar studies that have reported participation rates of 24.8-71.6% (8,19,13,23,28). In addition, there was no significant difference between participants and non-participants in terms of gender and age.…”

Section: Representativeness and Limitationsmentioning

confidence: 54%

Spina bifida and sexuality

Linstow¹,

Biering-Sørensen²,

Liebach³

et al. 2014

J Rehabil Med

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Results: Fifty-one percent of subjects regarded their sexual life as a failure or dysfunctional. However, 45% reported being satisfied with their sexual life. Participants with partners were more satisfied with their sexual life than those without partners. Faecal, but not urinary, incontinence was associated with poorer sexual function and less satisfaction. Fortynine percent of subjects indicated that the sexual education they received at puberty was useful; however, 32% lacked knowledge about their sexual functioning with regard to their disability. Conclusion: There is a need for further sexual education and counselling for adults with spina bifida in order to improve their sexuality and quality of life.

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Section: Representativeness and Limitationsmentioning

confidence: 54%

Spina bifida and sexuality

Linstow¹,

Biering-Sørensen²,

Liebach³

et al. 2014

J Rehabil Med

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“…5 Clean intermittent catheterization (CIC), the use of bladder-active medications (BAMs), and close urological follow-up can mitigate many of the potentially life-threatening complications of neurogenic bladder dysfunction, but patients' quality of life (QOL) is considerably affected by the lifelong burden of these interventions, the lack of control of their ability to empty their bladders, and by incontinence and sexual dysfunction. 4,5,9,10,13,15,21,25,[28][29][30] For more than 100 years, researchers and clinicians have pursued a myriad of surgical remedies to allow reinnervation of the urinary bladder, attempting a variety of nerve repair and transfer techniques in experimental animals and in humans. 11 While there has been great success in the clinical use of nerve transfer techniques to reinnervate peripheral nerves of the extremities, 3 there is no surgical nerve transfer or repair procedure that is widely used in patients with neurogenic bladder dysfunction.…”

mentioning

confidence: 99%

Lack of efficacy of an intradural somatic-to-autonomic nerve anastomosis (Xiao procedure) for bladder control in children with myelomeningocele and lipomyelomeningocele: results of a prospective, randomized, double-blind study

Tuite

Polsky²,

Homsy³

et al. 2016

PED

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OBJECTIVE Xiao et al. and other investigators have studied an intradural somatic-to-autonomic (e.g., L-5 to S3–4) nerve transfer as a method to create a reflex arc to allow bladder emptying in response to cutaneous stimulation (the Xiao procedure). In previous clinical studies of patients with spinal dysraphism who underwent the Xiao procedure, high success rates (70%–85%) were reported for the establishment of a “skin-CNS-bladder” reflex arc that allows spontaneous, controlled voiding in children with neurogenic bladder dysfunction. However, many of these studies did not use blinded observers, did not have control groups, and/or featured only limited follow-up durations. METHODS A randomized, prospective, double-blind trial was initiated in March 2009, enrolling children with myelomeningocele (MM), lipomyelomeningocele (LMM), and neurogenic bladder dysfunction who were scheduled for spinal cord detethering (DT) for the usual indications. At the time of DT, patients were randomized between 2 arms of the study: half of the patients underwent a standard spinal cord DT procedure alone (DT group) and half underwent DT as well as the Xiao procedure (DT+X group). Patients, families, and study investigators, all of whom were blinded to the surgical details, analyzed the patients' strength, sensory function, mobility, voiding, and urodynamic bladder function before surgery and at regular intervals during the 3-year follow-up. RESULTS Twenty patients were enrolled in the study: 10 underwent only DT and the other 10 underwent DT+X. The addition of the Xiao procedure to spinal cord DT resulted in longer operative times (p = 0.024) and a greater chance of wound infection (p = 0.03). Patients in both treatment arms could intermittently void or dribble small amounts of urine (< 20% total bladder capacity) in response to scratching in dermatomes T-9 through S-2 using a standardized protocol, but the voiding was not reproducible and the volume voided was not clinically useful in any patient. Voiding in response to scratching was not more frequent in patients who underwent DT+X compared with those who underwent only DT. Bladder contractions in response to scratching occurred in both treatment arms at various intervals after surgery, but they were not more reproducible or more frequent in the patients who underwent the Xiao procedure than in the patients who did not. No patient in either treatment arm was continent of urine before, during, or after the study. CONCLUSIONS Patients with MM and LMM who underwent the Xiao procedure during spinal cord DT were no more likely to be able to void, to control their urination, to achieve continence, or to have a demonstrable urodynamic bladder contraction in response to cutaneous stimulation than patients who underwent only spinal cord DT. This study, in the context of disappointing results reported in other recent studies of the Xiao procedure, raises doubts about the clinical applicability of this procedure in humans until further basic science research is performed.

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“…Dans notre étude, seules 40 % des femmes avaient eu au moins un rapport sexuel dans le mois précédent. Ces résultats correspondent à ceux rapportés évaluant leur fréquence de 10 à 57 % [5,7,10,12,16,17]. En revanche, ils sont nettement inférieurs à ceux de la population générale.…”

Section: Discussionunclassified

“…Elles indiquent que les principales sources d'altération sont une diminution de la sensibilité génitale dont la prévalence s'étend de 4 à 81 % et une anorgasmie dans plus de 70 % des cas [5,7,10,12,16,17]. Récemment, en utilisant le questionnaire Watts Sexual Function Questionnaire, Lassmann et al décrivaient une altération de l'ensemble des domaines étudiés, que ce soit le désir, l'excitation, l'orgasme et la satisfaction [8].…”

Section: Discussionunclassified

“…La vie sexuelle des hommes spina-bifida avec une myéloméningocèle a fait l'objet de multiples études [3][4][5][6][7][8][9][10][11][12][13][14][15]. En revanche, celle des femmes ayant une myéloméningocèle n'a fait l'objet que de très rares études limitées à de faibles effectifs [5,7,10,12,16,17]. De plus, aucune de ces études n'utilisait de questionnaire spécifique de la sexualité féminine.…”

Section: Introductionunclassified

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Évaluation de la fonction sexuelle des jeunes femmes ayant un spina-bifida avec une myéloméningocèle

et al. 2010

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Objectifs : Évaluer la sexualité des jeunes femmes adultes ayant un spina-bifida avec une myéloméningocèle. Matériel et méthodes : Une étude transversale a été réalisée auprès de 44 femmes spina-bifida avec une myéloméningo-cèle âgées en moyenne de 27,66 ± 5,89 ans. Un autoquestionnaire a été envoyé par courrier postal. Il comprenait le bref index de la fonction sexuelle féminine (BISF-W) et des questions portant sur le mode mictionnel, les symptômes urinaires, l'aisance matérielle, le lieu de vie et le statut marital. Parallèlement, un recueil de données provenant des dossiers médicaux de chirurgie pédiatrique des patientes ayant répondu aux questionnaires a été effectué. Résultats : Le taux de réponse était de 56,8 %. L'ensemble des domaines de la sexualité féminine était altéré (pensées et désir sexuels, excitation sexuelle, fréquence, réceptivité et initiative, orgasme, satisfaction relationnelle, gêne dans la vie sexuelle). Le principal facteur de cette altération était l'incontinence urinaire et sa sévérité reflétée par la nécessité ou non de porter des protections. En effet, elle s'associait à une diminution du désir, de l'excitation sexuelle, de l'initiative et de la réceptivité, et la nécessité de porter des protections constituait un frein à la sexualité. Conclusion : Les jeunes femmes adultes spina-bifida avec une myéloméningocèle ont une altération de l'ensemble des domaines de la sexualité. La présence d'une incontinence urinaire est associée à des scores de désir, de pensées, d'initiative, de réceptivité et d'excitation sexuelle plus faibles. Ces résultats plaident pour une prise en charge précoce de l'incontinence urinaire afin d'améliorer la sexualité de ces femmes.Mots clés Spina-bifida · Myéloméningocèle · Fonction sexuelle · Neuro-urologie · BISF-W Abstract Objectives: To assess young spina-bifida women with myelomeningocele sexual function. Material and methods: A cross-sectional study was performed in 44 women, mean age 27.66 ± 5.89 years, with spinabifida and myelomeningocele. A self-administrated questionnaire was mailed. It included the Brief Index of Sexual Functioning for Women and questions about the mode of micturition, urinary symptoms, social and economic status, lifestyle and marital status. In parallel, data from the paediatric surgery records of the patients who responded to the questionnaire were collected. Results: The response rate was 56.8 %. All domains of the female sexual function (thoughts and desires, arousal, frequency of sexual activity, receptivity and initiation, pleasure and orgasm, relationship satisfaction) were altered. Urinary incontinence was the main factor of sexual function alteration. It was associated with lower thoughts and desires, arousal and receptivity and initiation scores. Moreover, wearing pads constituted a limitation to achieve intimacy. Conclusion: Sexual function of young women with spinabifida and myelomeningocele is poor. Urinary incontinence induced poor desires, arousal, receptivity and initiative. These plead to an early management of urina...

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Predictors of Successful Sexual Partnering of Adults With Spina Bifida

Abstract: Sex counseling should be part of the regular medical care in patients with spina bifida. A difference exists between males and females when comparing lesion level and sexual activity.

Cited by 56 publications

References 20 publications

Spina bifida and sexuality

Spina bifida and sexuality

Lack of efficacy of an intradural somatic-to-autonomic nerve anastomosis (Xiao procedure) for bladder control in children with myelomeningocele and lipomyelomeningocele: results of a prospective, randomized, double-blind study

Évaluation de la fonction sexuelle des jeunes femmes ayant un spina-bifida avec une myéloméningocèle

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