Sexuality and seeking medical help for erectile dysfunction in young adults with spina bifida

The objectives of this study were to evaluate the correlation between the sexual function of spina bifida (SB) patients and Sharrard classification, touch sensation on the penis, to examine if SB patients who are sexually active have erectile dysfunction (ED) on the International Index of Erectile Function-5 (IIEF5), and to clarify if they seek medical treatment for ED.

Thirty-six male SB patients aged over 18 years were enrolled. A questionnaire was sent to all patients that included the following items: touch sensation on the penis, psychogenic erection, rigidity at erection, ejaculation, orgasm and experience in sexual intercourse. In addition, patients who had experience in sexual intercourse were asked about ED through the use of the IIEF5 and whether or not they sought medical help for their ED.

Twenty-six patients responded. The positive rates of psychogenic erection, rigidity at erection, ejaculation and orgasm were 85%, 54%, 88% and 65% respectively. Psychogenic erection and ejaculation correlated with Sharrard classification. Rigidity at erection and orgasm correlated with touch sensation on the penis. Eleven patients had experience in sexual intercourse and six of them were diagnosed as having ED on the IIEF5. There were no factors correlating with ED. None of the patients sought medical advice and none was treated for ED.

Sexual function of SB patients could be predicted by Sharrard classification and touch sensation on the penis to some degree. However, ED did not correlate with sexual function. Therefore, we should not evaluate the neurological loss but instead provide adequate information.