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Published on: April 18, 2011
Sexual Function During Primary Rehabilitation After Spinal Cord Injury: A Descriptive Analysis From a
Collene E Anderson1, Gideon Sartorius2, Sue Bertschy3
1Swiss Paraplegic Research, Nottwil; Department of Health Sciences and Medicine, University of Lucerne, Lucerne; Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich; Spinal Cord Injury Center, Balgrist University Hospital, University of Zürich, Zürich.
Objective:
To describe the distribution of and risk factors for sexual dysfunction (SD) and its symptoms, including altered arousal and orgasmic dysfunction, female menstrual dysfunction, and male erectile and ejaculatory dysfunction during primary spinal cord injury (SCI) rehabilitation.
Design:
Cross-sectional analyses of population-based cohort data.
Setting:
Four specialized SCI centers in Switzerland.
Participants:
A total of 605 individuals (N=605), including 140 females, aged ≥18 years with newly diagnosed SCI, who underwent inpatient postacute rehabilitation between May 2013 and July 2024, were included.
Interventions:
Not applicable.
Main Outcome Measures:
Outcomes were assessed using the International Spinal Cord Society female sexual and reproductive function, as well as the male sexual function (SF) basic data set.
Results:
At 4.8 months post-SCI (Q1-Q3, 3.3-5.8), 67% of females and 46% of males indicated that ≥1 SF outcome was "unknown." Among females, altered or absent reflex genital arousal and orgasmic function were reported by 57% and 60%, respectively, with 33% aged ≤51 years having menstrual dysfunction. In males, altered or absent psychogenic erection, reflex erection, ejaculation, and orgasmic function were reported by 75%, 70%, 76%, and 75%, respectively. Multivariable regression analyses yielded an association between SCI severity and dysfunction. In females, American Spinal Injury Association Impairment Scale (AIS) grades A and B (vs AIS C and D) nearly perfectly predicted both reflex arousal (P=.016) and orgasmic dysfunction (P=.07). In males, AIS A (vs AIS D) was highly predictive of SD in all symptom domains (all post hoc P<.001), as was older age (P≤.016, all).
Conclusions:
This study revealed high rates of SD in both females and males during inpatient rehabilitation after SCI. Future well-powered longitudinal studies are needed to generate accurate estimates of the prevalence of post-SCI SD, determine the optimal timing for SF assessment, and provide comprehensive biopsychosocial evaluations of sexual health after SCI.
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