Sexual Health in Men With Traumatic Spinal Cord Injuries: A Review and Recommendations for Primary Health-Care Providers

Abstract

Sexual health has been well established as a salient priority for men following traumatic spinal cord injury; yet, it continues to be under-addressed by health-care providers in both inpatient and community settings. Given that most men with traumatic spinal cord injuries will be followed by community-based primary health-care providers, including family physicians and nurse practitioners, for their long-term health-care needs, these clinicians are well positioned to address ongoing sexual health issues with this population. A scoping review of literature published between 2007 and 2017 inclusive was undertaken to identify what is known about the sexual health of men with spinal cord injuries. Twenty articles met the inclusion criteria. The findings are presented in four themes: (a) patterns and diversity of sexual health concerns; (b) sexual health recovery as an ongoing priority; (c) clinical barriers to addressing sexual health concerns, and (d) recommended interventions and strategies for primary health-care providers. The findings indicate that physiological changes as well as psychological and social factors influence men’s sexual function following spinal cord injury, and that sexual health recovery is an enduring rehabilitation priority. Several barriers including lack of sexual rehabilitation services and consensus around clinician roles, and societal stigmas related to disability and sexuality impede treatment. Attention to sexual health recovery has mainly focused on formal rehabilitation settings; however, many evidence-based clinical strategies and resources are relevant to and adaptable for primary care providers caring for these men in the community.

Quality of life in patients with tetraplegia and paraplegia after traumatic spinal cord injury

“…The quality of sexual life with interpersonal relations becomes particularly important, especially in persons with a marked reduction of independence [29,30]. Sexual functions are a very important factor in the QOL; recovery of these activities is the highest priority in patients with paraplegia and is in second place of priority in the tetraplegic patients after recovery of hand function [31,32]. Numerous studies have shown that sexual life is one of lower-graded components of the WHOQOL-BREF scale [33][34][35], with lower scores compared to the general population [36].…”

Sexual Knowledge and Experience of Women with Spinal Cord Injury in the Community Level in Bangladesh

“…Sexuality is vital in the process of accepting and coping with SCI and highlighted the importance of reproduction for women in general, before and after SCI, were also prominent [10]. Aikman et al [11] reported that lack of sexual rehabilitation services and consensus around clinician roles, and societal stigmas related to disability and sexuality obstruct treatment.…”

Improving Sexual Function by Using Focal Vibrations in Men with Spinal Cord Injury: Encouraging Findings from a Feasibility Study

“…Altogether, these concerns can worsen ED significantly. Changes in body image representation, depression, anxiety, and fatigue also contribute to worsen ED [5,6].…”

“…Whether achieved, reflexogenic, psychogenic, or mixed, erection is often short lasting and non-sufficient to maintain satisfactory sexual relations [5,6]. Frequency and quality of sexual activity inevitably decline after SCI.…”

“…Frequency and quality of sexual activity inevitably decline after SCI. This obviously represents a serious concern in people with SCI, as sexual activity is an important factor in quality of life and self-esteem [5,6]. Diminished or absent sexual activity does not mean absent sexuality, as the need for sexual expression and intimacy remains [7].…”