Predictive factors for sexual dissatisfaction in men after traumatic spinal cord injury
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Abstract
Introduction: In addition to motor and sensory losses, the urinary tract and sexual function are also affected by spinal cord injury, with sexual dysfunction being one of the most common problems in these patients and its severity depends on the level and complexity of the injury. This alteration of sexual function occurs due to changes in the neurophysiological process, but this mechanism and its association with sexual satisfaction are not well established. Objective: To analyze the association between clinical and psychosocial factors and sexual satisfaction in men after traumatic spinal cord injury, as well as predictive factors for sexual dissatisfaction after the injury. Method: Observational study performed with 45 men, with traumatic and sexually active spinal cord injury. The International Erectile Function Index assessed sexual function, and the level and grade of the lesion were determined following the guidelines of the International Standards for Neurological Examination and Functional Classification of Spinal Cord Injury. Bi and multivariate analysis was applied to observe the association between factors, with a significance level of 0.05. Results: 45 individuals with mean lesion time in years 7.5 (CI 5.2 - 9.9) were evaluated. Frequency of monthly sexual intercourse is a risk factor (OR: 11.69, 95% CI: 2.16 - 63.19) for sexual dissatisfaction, as well as orgastic dysfunction (OR: 10,13; 95% CI: 1, 33-77, 18). Conclusion: Infrequent sexual relations and orgastic dysfunction are predictors of sexual dissatisfaction after spinal cord injury.
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Sunilkumar M, Boston P, Rajagopal M. Views, and attitudes towards sexual functioning in men living with spinal cord injury in Kerala, South India. Indian J Palliat Care. 2015;21(1):12-20. https://doi.org/10.4103/0973-1075.150158
Alexander M, Aisen C, Alexander S, Aisen M. Sexual concerns after Spinal Cord Injury: An update on management. Neuro Rehabilitation. 2017;41(2):343-357. https://doi.org/10.3233/NRE-172202
Hultling C, Giuliano F, Quirk F, Peña 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. https://doi.org/10.1038/sj.sc.3101011
Dahlberg A, Alaranta HT, Kautiainen H, Kotila M. Sexual activity and satisfaction in men with traumatic spinal cord lesion. J Rehabil Med. 2007;39(2):152-5. https://doi.org/10.2340/16501977-0029
Hassan I, Cima RR. Quality of life after rectal resection and multimodality therapy. J Surg Oncol. 2007;96(8):684-92. https://doi.org/10.1002/jso.20916
Traa MJ, De Vries J, Roukema JA, Den Oudsten BL. Sexual (dys)function and the quality of sexual life in patients with colorectal cancer: a systematic review. Ann Oncol. 2012;23(1):19-27. https://doi.org/10.1093/annonc/mdr133
Cuenca AIC, Sampietro-Crespo A, Virseda-Chamorro M, Martín-Espinosa N. Psychological impact and sexual dysfunction in men with and without spinal cord injury. J Sex Med. 2015;12(2):436-44. https://doi.org/10.1111/jsm.12741
Smith AE, Molton IR, McMullen K, Jensen MP. Sexual Function, Satisfaction, and Use of Aids for Sexual Activity in Middle-Aged Adults with Long-Term Physical Disability. Top Spinal Cord Inj Rehabil. 2015;21(3):227-32. https://doi.org/10.1310%2Fsci2103-227
Krassioukov A, Elliott S. Neural Control and Physiology of Sexual Function: Effect of Spinal Cord Injury. Top Spinal Cord Inj Rehabil. 2017;23(1):1-10. https://doi.org/10.1310/sci2301-1
Vodušek DB. Lower urinary tract and sexual dysfunction in neurological patients. Eur Neurol. 2014;72(1-2):109-15. https://doi.org/10.1159/000360529
Courtois F, Charvier K. Sexual dysfunction in patients with spinal cord lesions. Handb Clin Neurol. 2015;130:225-45. https://doi.org/10.1016/b978-0-444-63247-0.00013-4
Sunilkumar MM, Boston P, Rajagopal MR. Sexual Functioning in Men Living with a Spinal Cord Injury-A Narrative Literature Review. Indian J Palliat Care. 2015;21(3):274-81. https://doi.org/10.4103/0973-1075.164886
Hou S, Rabchevsky AG. Autonomic consequences of spinal cord injury. Compr Physiol. 2014;4(4):1419-53. https://doi.org/10.1002/cphy.c130045
Biering-Sørensen I, Hansen RB, Biering-Sørensen F. Sexual function in a traumatic spinal cord injured population 10-45 years after injury. J Rehabil Med. 2012;44(11):926-31. https://doi.org/10.2340/16501977-1057
Ferro JKO, Lemos A, Silva CP, Lima CROP, Raposo MCF, Cavalcanti GA, et al. Predictive Factors of Male Sexual Dysfunction After Traumatic Spinal Cord Injury. Spine (Phila Pa 1976). 2019;44(17):1228-37. https://doi.org/10.1097/BRS.0000000000003049
Bampi LNS, Guilhem D, Lima DD. Qualidade de vida em pessoas com lesão medular traumática: um estudo com o WHOQOL-bref. Rev Bras Epidemiol. 2008;11(1):67-77. https://doi.org/10.1590/S1415-790X2008000100006
Khak M, Hassanijirdehi M, Afshari-Mirak S, Holakouie-Naieni K, Saadat S, Taheri T, et al. Evaluation of Sexual Function and Its Contributing Factors in Men With Spinal Cord Injury Using a Self-Administered Questionnaire. Am J Mens Health. 2016;10(1):24-31. https://doi.org/10.1177/1557988314555122
Bertolucci PH, Brucki S, Campacci SR, Juliano Y. The Mini-Mental State Examination in an outpatient population: influence of literacy. Arq Neuropsiquiatr. 1994;52(1):01-07. https://dx.doi.org/10.1590/S0004-282X1994000100001
Brucki SM, Nitrini R, Caramelli P, Bertolucci PH, Okamoto IH. Sugestões para o uso do mini-exame do estado mental no Brasil [Suggestions for utilization of the mini-mental state examination in Brazil]. Arq Neuropsiquiatr. 2003;61(3B):777-81. https://doi.org/10.1590/s0004-282x2003000500014
Beck AT, Steer RA, Carbin MG. Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clin Psychol Rev. 1988;8(1):77-100. https://doi.org/10.1016/0272-7358(88)90050-5
Cunha JA. Manual da versão em português das Escalas Beck. São Paulo: Casa do Psicólogo; 2001. p. 11-13.
Gomes-Oliveira MH, Gorenstein C, Lotufo Neto F, Andrade LH, Wang YP. Validation of the Brazilian Portuguese version of the Beck Depression Inventory-II in a community sample. Braz J Psychiatry. 2012;34(4):389-94. https://doi.org/10.1016/j.rbp.2012.03.005
Kirshblum SC, Burns SP, Biering-Sorensen F, Donovan W, Graves DE, Jha A, et al. International standards for neurological classification of spinal cord injury (revised 2011). J Spinal Cord Med. 2011;34(6):535-46. https://doi.org/10.1179/204577211x13207446293695
Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The International Index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997;49(6):822-30. https://doi.org/10.1016/s0090-4295(97)00238-0
Cappelleri JC, Rosen RC, Smith MD, Mishra A, Osterloh IH. Diagnostic evaluation of the erectile function domain of the International Index of Erectile Function. Urology. 1999;54(2):346-51. https://doi.org/10.1016/s0090-4295(99)00099-0
Gonzáles AI, Sties SW, Wittkopf PG, Mara LS, Ulbrich AZ, Cardoso FL, et al. Validação do Índice Internacional de Função Erétil (IIFE) para uso no Brasil. Arq Bras Cardiol. 2013;101(2):176-82. https://doi.org/10.5935/abc.20130141
Torrecilha LA, Costa BT, Lima FB, Santos SMS, Souza RB. O perfil da sexualidade em homens com lesão medular. Fisioter Mov. 2014;27(1):39-48. https://doi.org/10.1590/0103-5150.027.001.AO04
Derakhshanrad N, Yekaninejad MS, Vosoughi F, Fazel FS, Saberi H. Epidemiological study of traumatic spinal cord injuries: experience from a specialized spine center in Iran. Spinal Cord. 2016;54(10):901-7. https://doi.org/10.1038/sc.2016.10
Miranda EP, Gomes CM, Bessa J Jr, Abdo CHJ, Bellucci CHS, Castro Filho JE, et al. Evaluation of Sexual Dysfunction in Men With Spinal Cord Injury Using the Male Sexual Quotient. Arch Phys Med Rehabil. 2016;97(6):947-52. https://doi.org/10.1016/j.apmr.2016.01.005
Dryden DM, Saunders LD, Rowe BH, May LA, Yiannakoulias N, Svenson LW, et al. Depression following traumatic spinal cord injury. Neuroepidemiology. 2005;25(2):55-61. https://doi.org/10.1159/000086284
Dorsett P, Geraghty T, Sinnott A, Acland R. Hope, coping and psychosocial adjustment after spinal cord injury. Spinal Cord Ser Cases. 2017;3:17046. https://doi.org/10.1038/scsandc.2017.46
Phillips E, Carpenter C, Oates RD. Ejaculatory dysfunction. Urol Clin North Am. 2014;41(1):115-128.
Dimitriadis F, Karakitsios K, Tsounapi P, Tsambalas S, Loutradis D, Kanakas N, et al. Erectile function, and male reproduction in men with spinal cord injury: a review. Andrologia. 2010;42(3):139-65. https://doi.org/10.1111/j.1439-0272.2009.00969.x
Fode M, Ohl DA, Sønksen J. A step-wise approach to sperm retrieval in men with neurogenic anejaculation. Nat Rev Urol. 2015;12(11):607-16. https://doi.org/10.1038/nrurol.2015.241
Hess MJ, Hough S. Impact of spinal cord injury on sexuality: broad-based clinical practice intervention and practical application. J Spinal Cord Med. 2012;35(4):211-8. https://doi.org/10.1179/2045772312y.0000000025
Barbonetti A, Vassallo MR, Pacca F, Cavallo F, Costanzo M, Felzani G, et al. Correlates of low testosterone in men with chronic spinal cord injury. Andrology. 2014;2(5):721-8. https://doi.org/10.1111/j.2047-2927.2014.00235.x
Schoeller SD, Grumann ARS, Martini AC, Forner S, Sader LT, Nogueira GC. Knowing to care: characterization of individuals with spinal cord injury treated at a rehabilitation center. Fisioter Mov. 2015;28(1):77-83. https://doi.org/10.1590/0103-5150.028.001.AO08