Skip to main content
Top
Published in: Current Sexual Health Reports 4/2020

01-12-2020 | Erectile Dysfunction | Medical Comorbidities (O Raheem and J Kovac, Section Editors)

Sexual Dysfunction After Spinal Cord Injury

Authors: Aleena Ali, Emad Ibrahim

Published in: Current Sexual Health Reports | Issue 4/2020

Login to get access

Abstract

Purpose of Review

Spinal cord injury (SCI) has a massive impact on sexual function in the affected population. Discussion of male and female sexual dysfunction in patients with SCI including the currently known management/treatment options is presented in this review.

Recent Findings

Sexual dysfunction is an important aspect of daily life that needs to be acknowledged, discussed and managed following spinal cord injury. There are pharmaceutical and technological advancements which allow patients to adjust to their new norm. Discussion about sexuality following injury should be normalized and encouraged since it is entirely possible to have a healthy sexual relationship following injury.

Summary

Although there have been major strides in management of male sexual dysfunction following spinal cord injury, the same is not the case for their female counterparts. More research needs to be done on female sexual dysfunction, especially within the scope of patients with spinal cord injury since this is one of the major determinants owing towards quality of life for many individuals.
Literature
6.
go back to reference Monga M, Bernie J, Rajasekaran M. Male infertility and erectile dysfunction in spinal cord injury: a review. ArchPhysMedRehabil. 1999;80(10):1331–9. Monga M, Bernie J, Rajasekaran M. Male infertility and erectile dysfunction in spinal cord injury: a review. ArchPhysMedRehabil. 1999;80(10):1331–9.
7.
go back to reference Lue TF. Physiology of penile erection and pathophysiology of erectile dysfunction. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2012. p. 591–615. Lue TF. Physiology of penile erection and pathophysiology of erectile dysfunction. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2012. p. 591–615.
9.
go back to reference Anderson KD. Targeting recovery: priorities of the spinal cord-injured population. J Neruotrauma. 2004;21(10):1371–83.CrossRef Anderson KD. Targeting recovery: priorities of the spinal cord-injured population. J Neruotrauma. 2004;21(10):1371–83.CrossRef
10.
go back to reference Anderson KD, Borisoff JF, Johnson RD, Stiens SA, Elliott SL. The impact of spinal cord injury on sexual function: concerns of the general population. Spinal Cord. 2006;45(5):328–37.CrossRef Anderson KD, Borisoff JF, Johnson RD, Stiens SA, Elliott SL. The impact of spinal cord injury on sexual function: concerns of the general population. Spinal Cord. 2006;45(5):328–37.CrossRef
14.
go back to reference Brown J, Lindsey L. Sexuality in males with spinal cord injury. Tuscaloosa: University of Alabama; 1994. Brown J, Lindsey L. Sexuality in males with spinal cord injury. Tuscaloosa: University of Alabama; 1994.
17.
go back to reference Ohl DA, Quallich SA, Sonksen J, Brackett NL, Lynne CM. Anejaculation and retrograde ejaculation. UrolClinNorth Am. 2008;35(2):211–20. Ohl DA, Quallich SA, Sonksen J, Brackett NL, Lynne CM. Anejaculation and retrograde ejaculation. UrolClinNorth Am. 2008;35(2):211–20.
19.
go back to reference Brackett NL, Ibrahim E, Iremashvili V, Aballa TC, Lynne CM. Treatment for ejaculatory dysfunction in men with spinal cord injury: an 18-year single center experience. J Urol. 2010;183(6):2304–8.CrossRef Brackett NL, Ibrahim E, Iremashvili V, Aballa TC, Lynne CM. Treatment for ejaculatory dysfunction in men with spinal cord injury: an 18-year single center experience. J Urol. 2010;183(6):2304–8.CrossRef
21.
go back to reference Kathiresan AS, Ibrahim E, Aballa TC, Attia GR, Ory SJ, Hoffman DI, et al. Comparison of in vitro fertilization/intracytoplasmic sperm injection outcomes in male factor infertility patients with and without spinal cord injuries. Fertil Steril. 2011;96(3):562–6.CrossRef Kathiresan AS, Ibrahim E, Aballa TC, Attia GR, Ory SJ, Hoffman DI, et al. Comparison of in vitro fertilization/intracytoplasmic sperm injection outcomes in male factor infertility patients with and without spinal cord injuries. Fertil Steril. 2011;96(3):562–6.CrossRef
26.
go back to reference Rosen RC, Cappelleri JC, Gendrano N III. The international index of erectile function (IIEF): a state-of-the-science review. IntJ ImpotRes. 2002;14(4):226–44. Rosen RC, Cappelleri JC, Gendrano N III. The international index of erectile function (IIEF): a state-of-the-science review. IntJ ImpotRes. 2002;14(4):226–44.
32.
go back to reference Madeira CR, Tonin FS, Fachi MM, Borba HH, Ferreira VL, Leonart LP, et al. Efficacy and safety of oral phosphodiesterase 5 inhibitors for erectile dysfunction: a network meta-analysis and multicriteria decision analysis. World J Urol. 2020. https://doi.org/10.1007/s00345-020-03233-9. Madeira CR, Tonin FS, Fachi MM, Borba HH, Ferreira VL, Leonart LP, et al. Efficacy and safety of oral phosphodiesterase 5 inhibitors for erectile dysfunction: a network meta-analysis and multicriteria decision analysis. World J Urol. 2020. https://​doi.​org/​10.​1007/​s00345-020-03233-9.
35.
go back to reference Bors E, Comarr AE. Neurological disturbances of sexual function with special reference to 529 patients with spinal cord injury. Urol Surv. 1960;10:191–222. Bors E, Comarr AE. Neurological disturbances of sexual function with special reference to 529 patients with spinal cord injury. Urol Surv. 1960;10:191–222.
36.
go back to reference Golji H. Experience with penile prosthesis in spinal cord injury patients. J Urol. 1979;121:288–9.CrossRef Golji H. Experience with penile prosthesis in spinal cord injury patients. J Urol. 1979;121:288–9.CrossRef
37.
go back to reference Wyndaele JJ, de Meyer JM, de Sy WA, Claessens H. Intracavernous injection of vasoactive drugs, an alternative for treating impotence in spinal cord injury patients. Paraplegia. 1986;24:271–5.PubMed Wyndaele JJ, de Meyer JM, de Sy WA, Claessens H. Intracavernous injection of vasoactive drugs, an alternative for treating impotence in spinal cord injury patients. Paraplegia. 1986;24:271–5.PubMed
38.
go back to reference Chao R, Clowers DE. Experience with intracavernosal tri-mixture for the management of neurogenic erectile dysfunction. Arch Phys Med Rehabil. 1994;75(3):276–8.CrossRef Chao R, Clowers DE. Experience with intracavernosal tri-mixture for the management of neurogenic erectile dysfunction. Arch Phys Med Rehabil. 1994;75(3):276–8.CrossRef
40.
go back to reference Bodner DR, Haas CA, Krueger B, Seftel AD. Intraurethral alprostadil for treatment of erectile dysfunction in patients with spinal cord injury. Urology. 1999;53(1):199–202.CrossRef Bodner DR, Haas CA, Krueger B, Seftel AD. Intraurethral alprostadil for treatment of erectile dysfunction in patients with spinal cord injury. Urology. 1999;53(1):199–202.CrossRef
41.
go back to reference FA D, WW D, M F, BP G, CA G, MC M, et al. Efficacy and safety of oral sildenafil (Viagra) in men with erectile dysfunction caused by spinal cord injury. Neurology. 1998;51(6):1629–33.CrossRef FA D, WW D, M F, BP G, CA G, MC M, et al. Efficacy and safety of oral sildenafil (Viagra) in men with erectile dysfunction caused by spinal cord injury. Neurology. 1998;51(6):1629–33.CrossRef
42.
go back to reference Giuliano F, Hultling C, El Masry WS, Smith MD, Osterloh IH, Orr M, et al. Randomized trial of sildenafil for the treatment of erectile dysfunction in spinal cord injury. Sildenafil Study Group AnnNeurol. 1999;46(1):15–21. Giuliano F, Hultling C, El Masry WS, Smith MD, Osterloh IH, Orr M, et al. Randomized trial of sildenafil for the treatment of erectile dysfunction in spinal cord injury. Sildenafil Study Group AnnNeurol. 1999;46(1):15–21.
43.
go back to reference • Hultling C, Giuliano F, Quirk F, Pena B, Mishra A, Smith MD. Quality of life in patients with spinal cord injury receiving Viagra (sildenafil citrate) for the treatment of erectile dysfunction. Spinal cord. 2000;38(6):363–70 Sildenafil is effective for ED in males with SCI.CrossRef • Hultling C, Giuliano F, Quirk F, Pena B, Mishra A, Smith MD. Quality of life in patients with spinal cord injury receiving Viagra (sildenafil citrate) for the treatment of erectile dysfunction. Spinal cord. 2000;38(6):363–70 Sildenafil is effective for ED in males with SCI.CrossRef
44.
go back to reference MC M, FA D, WW D, CA G, MD S, M O, et al. A two-part study of sildenafil (VIAGRA) in men with erectile dysfunction caused by spinal cord injury. Spinal Cord. 1999;37(2):110–6.CrossRef MC M, FA D, WW D, CA G, MD S, M O, et al. A two-part study of sildenafil (VIAGRA) in men with erectile dysfunction caused by spinal cord injury. Spinal Cord. 1999;37(2):110–6.CrossRef
46.
go back to reference Sanchez RA, Vidal J, Jauregui ML, Barrera M, Recio C, Giner M, et al. Efficacy, safety and predictive factors of therapeutic success with sildenafil for erectile dysfunction in patients with different spinal cord injuries. Spinal Cord. 2001;39(12):637–43.CrossRef Sanchez RA, Vidal J, Jauregui ML, Barrera M, Recio C, Giner M, et al. Efficacy, safety and predictive factors of therapeutic success with sildenafil for erectile dysfunction in patients with different spinal cord injuries. Spinal Cord. 2001;39(12):637–43.CrossRef
47.
go back to reference Giuliano F, Rubio-Aurioles E, Kennelly M, Montorsi F, Kim ED, Finkbeiner AE, et al. Vardenafil improves ejaculation success rates and self-confidence in men with erectile dysfunction due to spinal cord injury. Spine. 2008;33(7):709–15. Giuliano F, Rubio-Aurioles E, Kennelly M, Montorsi F, Kim ED, Finkbeiner AE, et al. Vardenafil improves ejaculation success rates and self-confidence in men with erectile dysfunction due to spinal cord injury. Spine. 2008;33(7):709–15.
48.
go back to reference Giuliano F, Rubio-Aurioles E, Kennelly M, Montorsi F, Kim ED, Finkbeiner AE, et al. Efficacy and safety of vardenafil in men with erectile dysfunction caused by spinal cord injury. Neurology. 2006;66(2):210–6. Giuliano F, Rubio-Aurioles E, Kennelly M, Montorsi F, Kim ED, Finkbeiner AE, et al. Efficacy and safety of vardenafil in men with erectile dysfunction caused by spinal cord injury. Neurology. 2006;66(2):210–6.
49.
go back to reference Denil J, Ohl DA, Smythe C. Vacuum erection device in spinal cord injured men: patient and partner satisfaction. ArchPhysMedRehabil. 1996;77(8):750–3. Denil J, Ohl DA, Smythe C. Vacuum erection device in spinal cord injured men: patient and partner satisfaction. ArchPhysMedRehabil. 1996;77(8):750–3.
50.
go back to reference Lloyd EE, Toth LL, Perkash I. Vacuum tumescence: an option for spinal cord injured males with erectile dysfunction. Sci Nursing. 1989;6:25–8.PubMed Lloyd EE, Toth LL, Perkash I. Vacuum tumescence: an option for spinal cord injured males with erectile dysfunction. Sci Nursing. 1989;6:25–8.PubMed
51.
go back to reference Rivas DA, Chancellor MB. Complications associated with the use of vacuum constriction devices for erectile dysfunction in the spinal cord injured population. J AmParaplegia Soc. 1994;17(3):136–9.CrossRef Rivas DA, Chancellor MB. Complications associated with the use of vacuum constriction devices for erectile dysfunction in the spinal cord injured population. J AmParaplegia Soc. 1994;17(3):136–9.CrossRef
53.
go back to reference Althof SE, Levine SB. Clinical approach to the sexuality of patients with spinal cord injury. Urol Clin North Am. 1993;20(3):527–34.PubMed Althof SE, Levine SB. Clinical approach to the sexuality of patients with spinal cord injury. Urol Clin North Am. 1993;20(3):527–34.PubMed
54.
go back to reference Smith EM, Bodner DR. Sexual dysfunction after spinal cord injury. Urol Clin North Am. 1993;20(3):535–42.PubMed Smith EM, Bodner DR. Sexual dysfunction after spinal cord injury. Urol Clin North Am. 1993;20(3):535–42.PubMed
55.
go back to reference Elliott S. Ejaculation and orgasm: sexuality in men with SCI. Top Spinal Cord Inj Rehabil. 2002;8(8):1–15.CrossRef Elliott S. Ejaculation and orgasm: sexuality in men with SCI. Top Spinal Cord Inj Rehabil. 2002;8(8):1–15.CrossRef
56.
go back to reference Elliott S. Sexual dysfunction and infertility in men with spinal cord disorders. In: Lin V, editor. Spinal cord medicine: principles and practice. New York: Demos Medical Publishing; 2003. p. 349–65. Elliott S. Sexual dysfunction and infertility in men with spinal cord disorders. In: Lin V, editor. Spinal cord medicine: principles and practice. New York: Demos Medical Publishing; 2003. p. 349–65.
57.
go back to reference •• Lim CAR, Nightingale TE, Elliott S, Krassioukov AV. Lifestyle modifications and pharmacological approaches to improve sexual function and satisfaction in men with spinal cord injury: a narrative review. Spinal cord. 2020;58(4):391–401. https://doi.org/10.1038/s41393-019-0404-zEffective holistic management of sexual health in SCI males.CrossRefPubMed •• Lim CAR, Nightingale TE, Elliott S, Krassioukov AV. Lifestyle modifications and pharmacological approaches to improve sexual function and satisfaction in men with spinal cord injury: a narrative review. Spinal cord. 2020;58(4):391–401. https://​doi.​org/​10.​1038/​s41393-019-0404-zEffective holistic management of sexual health in SCI males.CrossRefPubMed
59.
61.
go back to reference Faubion SS, Rullo JE. Sexual dysfunction in women: a practical approach. Am Fam Physician. 2015;92(4):281–8.PubMed Faubion SS, Rullo JE. Sexual dysfunction in women: a practical approach. Am Fam Physician. 2015;92(4):281–8.PubMed
65.
go back to reference Komisaruk BR, Whipple B, Crawford A, Liu WC, Kalnin A, Mosier K. Brain activation during vaginocervical self-stimulation and orgasm in women with complete spinal cord injury: fMRI evidence of mediation by the vagus nerves. Brain Res. 2004;1024(1–2):77–88.CrossRef Komisaruk BR, Whipple B, Crawford A, Liu WC, Kalnin A, Mosier K. Brain activation during vaginocervical self-stimulation and orgasm in women with complete spinal cord injury: fMRI evidence of mediation by the vagus nerves. Brain Res. 2004;1024(1–2):77–88.CrossRef
66.
go back to reference Sipski ML, Alexander CJ, Rosen R. Sexual arousal and orgasm in women: effects of spinal cord injury. AnnNeurol. 2001;49(1):35–44. Sipski ML, Alexander CJ, Rosen R. Sexual arousal and orgasm in women: effects of spinal cord injury. AnnNeurol. 2001;49(1):35–44.
71.
go back to reference Sipski M, Alexander C, Rosen R. Orgasm in women with spinal cord injuries: a laboratory assessment. Arch Phys Med Rehabil. 1995;76(12):1097–102.CrossRef Sipski M, Alexander C, Rosen R. Orgasm in women with spinal cord injuries: a laboratory assessment. Arch Phys Med Rehabil. 1995;76(12):1097–102.CrossRef
74.
go back to reference Wilson SK, Delk JR 2nd, Billups KL. Treating symptoms of female sexual arousal disorder with the Eros-clitoral therapy device. J Gend Specif Med. 2001;4(2):54–8.PubMed Wilson SK, Delk JR 2nd, Billups KL. Treating symptoms of female sexual arousal disorder with the Eros-clitoral therapy device. J Gend Specif Med. 2001;4(2):54–8.PubMed
Metadata
Title
Sexual Dysfunction After Spinal Cord Injury
Authors
Aleena Ali
Emad Ibrahim
Publication date
01-12-2020
Publisher
Springer US
Published in
Current Sexual Health Reports / Issue 4/2020
Print ISSN: 1548-3584
Electronic ISSN: 1548-3592
DOI
https://doi.org/10.1007/s11930-020-00296-y

Other articles of this Issue 4/2020

Current Sexual Health Reports 4/2020 Go to the issue

Current Controversies (P Kleinplatz & C Carson, Section Editor)

Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction

Sociocultural Issues and Epidemiology (J Abdulcadir & D Bader, Section Editors)

Re-thinking the Zero Tolerance Approach to FGM/C: the Debate Around Female Genital Cosmetic Surgery

Male Sexual Dysfunction and Disorder (N Thirumavalavan, Section Editors)

Comparing Outcomes of Grafts Used in Peyronie’s Disease Surgery: a Systematic Review

Sociocultural Issues and Epidemiology (J Abdulcadir & D Bader, Section Editors)

Zero Tolerance for Genital Mutilation: a Review of Moral Justifications

Medical Comorbidities (O Raheem and J Kovac, Section Editors)

Sexual Health in the Elderly Population