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European Spine Journal
Published in: European Spine Journal 3/2016

Open Access 01-03-2016 | Original Article

Discussing sexual health in spinal care

Authors: N. S. Korse, M. P. J. Nicolai, S. Both, C. L. A. Vleggeert-Lankamp, H. W. Elzevier

Published in: European Spine Journal | Issue 3/2016

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Abstract

Background

The possible detrimental effects of spinal disease on sexual health are widely recognized; however, it is not known to what extent neurosurgeons discuss this topic with their patients. The aim of this study is to identify knowledge, attitude and practice patterns of neurosurgeons counseling their patients about sexual health.

Methods

All members of the Dutch Association of Neurosurgery (neurosurgeons and residents) were sent a questionnaire addressing their attitudes, knowledge and practice patterns regarding discussing sexual health.

Results

Response rate was 62 % with 89 questionnaires suitable for analysis. The majority of participants (83 %) were male; mean age, 42.4 years. The mean experience in neurosurgical practice was 9 years. Respondents assumed that in 34 % of their patients, sexual health was affected due to spinal disease. The majority of respondents (64 %) stated that responsibility for discussing sexual health lies (partly) with the neurosurgeon; however, 73 % indicated to (almost) never do this. The main reasons for not discussing sexual health were patients’ old age (42 %), lack of knowledge (38 %) and lack of patients’ initiative to bring up the subject (36 %). Twenty-six percent indicated lack of time as a reason. There was no evidence for gender or doctor’s age discordance as important barriers. Fifty percent of participants wished to gain more knowledge on discussing sexual health with patients.

Conclusion

This study shows that despite high prevalence of sexual dysfunction (SD) in spinal patients, counseling about sexual health is not often done in neurosurgical care. More training on sexual health counseling early in the residency program seems critical. By initiating the discussion, clinicians who deal with spinal patients have the potential to detect sexual dysfunction (SD) and to refer adequately when necessary, thereby improving overall quality of life of their patients.
Appendix
Available only for authorised users
Footnotes
1
Questionnaire is available upon request.
 
Literature
1.
Munro D, Horne HW Jr, Paull DP (1948) The effect of injury to the spinal cord and cauda equina on the sexual potency of men. N Engl J Med 239(24):903–911CrossRefPubMed
2.
Talbot HS (1949) A report on sexual function in paraplegics. J Urol 61(2):265–270PubMed
3.
Talbot HS (1955) The sexual function in paraplegia. J Urol 73(1):91–100PubMed
4.
Zeitlin AB, Cottrell TL, Lloyd FA (1957) Sexology of the paraplegic male. Fertil Steril 8(4):337–344PubMed
5.
Weiss AJ, Diamond MD (1966) Sexual adjustment, identification, and attitudes of patients with myelopathy. Arch Phys Med Rehabil 47(4):245–250PubMed
6.
Jochheim KA, Wahle H (1970) A study on sexual function in 56 male patients with complete irreversible lesions of the spinal cord and cauda equina. Paraplegia 8(3):166–172CrossRefPubMed
7.
8.
Benevento BT, Sipski ML (2002) Neurogenic bladder, neurogenic bowel, and sexual dysfunction in people with spinal cord injury. Phys Ther 82(6):601–612PubMed
9.
Nikoobakht M et al (2014) Sexual function and associated factors in Iranian patients with chronic low back pain. Spinal Cord 52(4):307–312CrossRefPubMed
10.
Teal JC, Athelstan GT (1975) Sexuality and spinal cord injury: some psychosocial considerations. Arch Phys Med Rehabil 56(6):264–268PubMed
11.
Kreuter M, Sullivan M, Siosteen A (1996) Sexual adjustment and quality of relationship in spinal paraplegia: a controlled study. Arch Phys Med Rehabil 77(6):541–548CrossRefPubMed
12.
Alexander CJ, Sipski ML, Findley TW (1993) Sexual activities, desire, and satisfaction in males pre- and post-spinal cord injury. Arch Sex Behav 22(3):217–228CrossRefPubMed
13.
Sipski ML, Alexander CJ, Rosen RC (1995) Orgasm in women with spinal cord injuries: a laboratory-based assessment. Arch Phys Med Rehabil 76(12):1097–1102CrossRefPubMed
14.
Sipski ML, Alexander CJ, Rosen RC (1999) Sexual response in women with spinal cord injuries: implications for our understanding of the able bodied. J Sex Marital Ther 25(1):11–22CrossRefPubMed
15.
Sipski ML, Alexander CJ, Rosen R (2001) Sexual arousal and orgasm in women: effects of spinal cord injury. Ann Neurol 49(1):35–44CrossRefPubMed
16.
Sipski ML (2001) Sexual function in women with neurologic disorders. Phys Med Rehabil Clin N Am 12(1):79–90PubMed
17.
Korse NS et al (2013) Complaints of micturition, defecation and sexual function in cauda equina syndrome due to lumbar disk herniation: a systematic review. Eur Spine J 22(5):1019–1029CrossRefPubMedPubMedCentral
18.
Tamburrelli FC et al (2014) Cauda equina syndrome: evaluation of the clinical outcome. Eur Rev Med Pharmacol Sci 18(7):1098–1105PubMed
19.
Siosteen A et al (1990) Sexual ability, activity, attitudes and satisfaction as part of adjustment in spinal cord-injured subjects. Paraplegia 28(5):285–295CrossRefPubMed
20.
21.
Cole TM, Chilgren R, Rosenberg P (1973) A new programme of sex education and counselling for spinal cord injured adults and health care professionals. Paraplegia 11(2):111–124CrossRefPubMed
22.
Nicolai MP et al (2013) Discussing sexual function in the cardiology practice. Clin Res Cardiol 102(5):329–336CrossRefPubMed
23.
Asch DA, Jedrziewski MK, Christakis NA (1997) Response rates to mail surveys published in medical journals. J Clin Epidemiol 50(10):1129–1136CrossRefPubMed
24.
25.
VanGeest JB, Johnson TP, Welch VL (2007) Methodologies for improving response rates in surveys of physicians: a systematic review. Eval Health Prof 30(4):303–321CrossRefPubMed
26.
Higgins GE Jr (1979) Sexual response in spinal cord injured adults: a review of the literature. Arch Sex Behav 8(2):173–196CrossRefPubMed
27.
Turk R, Turk M, Assejev V (1983) The female paraplegic and mother-child relations. Paraplegia 21(3):186–191CrossRefPubMed
28.
Gott M, Hinchliff S, Galena E (2004) General practitioner attitudes to discussing sexual health issues with older people. Soc Sci Med 58(11):2093–2103CrossRefPubMed
29.
Gott M et al (2004) “Opening a can of worms”: GP and practice nurse barriers to talking about sexual health in primary care. Fam Pract 21(5):528–536CrossRefPubMed
30.
Burd ID, Nevadunsky N, Bachmann G (2006) Impact of physician gender on sexual history taking in a multispecialty practice. J Sex Med 3(2):194–200CrossRefPubMed
31.
Larsen E, Hejgaard N (1984) Sexual dysfunction after spinal cord or cauda equina lesions. Paraplegia 22(2):66–74CrossRefPubMed
32.
Metz ME, Seifert MH Jr (1990) Men’s expectations of physicians in sexual health concerns. J Sex Marital Ther 16(2):79–88CrossRefPubMed
33.
Clark RD, Williams AA (2014) Patient preferences in discussing sexual dysfunctions in primary care. Fam Med 46(2):124–128PubMed
34.
Bachmann G (2006) Female sexuality and sexual dysfunction: are we stuck on the learning curve? J Sex Med 3(4):639–645CrossRefPubMed
35.
Vollmer S et al (1989) Improving the preparation of preclinical students for taking sexual histories. Acad Med 64(8):474–479CrossRefPubMed
36.
Rosen R et al (2006) Sexual communication skills in residency training: the Robert Wood Johnson model. J Sex Med 3(1):37–46CrossRefPubMed
37.
Sipski ML, Alexander CJ (2002) Documentation of the impact of spinal cord injury on female sexual function: the female spinal sexual function classification. Top Spinal Cord Inj Rehabil 8(1):63–73CrossRef
38.
39.
Fisher TL et al (2002) Sexual health after spinal cord injury: a longitudinal study. Arch Phys Med Rehabil 83(8):1043–1051CrossRefPubMed
40.
Sipski ML et al (2000) Sildenafil effects on sexual and cardiovascular responses in women with spinal cord injury. Urology 55(6):812–815CrossRefPubMed
41.
Derry F et al (2002) Efficacy and safety of sildenafil citrate (Viagra) in men with erectile dysfunction and spinal cord injury: a review. Urology 60(2 Suppl 2):49–57CrossRefPubMed
42.
Rahimi-Movaghar V, Vaccaro AR (2012) Management of sexual disorders in spinal cord injured patients. Acta Med Iran 50(5):295–299PubMed
43.
Abdolrasulnia M et al (2010) Management of female sexual problems: perceived barriers, practice patterns, and confidence among primary care physicians and gynecologists. J Sex Med 7(7):2499–2508CrossRefPubMed
44.
Alarcao V et al (2012) General practitioners’ knowledge, attitudes, beliefs, and practices in the management of sexual dysfunction-results of the Portuguese SEXOS study. J Sex Med 9(10):2508–2515CrossRefPubMed
Metadata
Title
Discussing sexual health in spinal care
Authors
N. S. Korse
M. P. J. Nicolai
S. Both
C. L. A. Vleggeert-Lankamp
H. W. Elzevier
Publication date
01-03-2016
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 3/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-015-3991-1

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