Volume 13, Issue 1 (2-2025)
J Surg Trauma 2025, 13(1): 1-7 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Soleimanian A, Salehi M, Kooshafar S, Nemati Karimooy F, Davoodi A, Mir Akhorli F, et al . Sexual Dysfunction Following Spinal Cord Injury: Insights into Pathophysiology and Management Approaches. J Surg Trauma 2025; 13 (1) :1-7
URL: http://jsurgery.bums.ac.ir/article-1-451-en.html
URL: http://jsurgery.bums.ac.ir/article-1-451-en.html
Amirmohammad Soleimanian 
, Maryam Salehi , Saeed Kooshafar , Farsad Nemati Karimooy , Alireza Davoodi , Farhang Mir Akhorli , Seyed Ali Shariat Razavi , Neda Kamandi , Hamideh Feiz * , Mohsen Khamoushi Kahdouee
, Maryam Salehi , Saeed Kooshafar , Farsad Nemati Karimooy , Alireza Davoodi , Farhang Mir Akhorli , Seyed Ali Shariat Razavi , Neda Kamandi , Hamideh Feiz * , Mohsen Khamoushi Kahdouee
Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract: (321 Views)
Spinal cord injury (SCI) significantly affects sexual function in both men and women. This review explores the impact of SCI on sexual dysfunction and discusses current management and treatment options. Addressing sexual dysfunction is crucial for improving the quality of life for individuals with SCI. Advances in pharmaceuticals and technology have provided new ways for patients to adapt to their changed circumstances. Encouraging open conversations about sexuality after an injury is vital, as maintaining a fulfilling sexual relationship following SCI is entirely achievable. Although significant strides have been made in addressing male sexual dysfunction related to SCI, advancements in managing female sexual dysfunction remain comparatively limited. More research is needed in this area, particularly for women with SCI, as sexual health is a key component of overall well-being.
Type of Study: Review |
Subject:
Neurosurgery
Received: 2024/09/17 | Accepted: 2024/12/19 | ePublished ahead of print: 2025/04/13 | Published: 2025/04/22
Received: 2024/09/17 | Accepted: 2024/12/19 | ePublished ahead of print: 2025/04/13 | Published: 2025/04/22
References
1. Center NSCI. Spinal cord injury facts and figures at a glance. J Spinal Cord Med. 2014;37(3):355-356. [DOI:10.1179/1079026814Z.000000000260]
2. Kathnelson JD, Kurtz Landy CM, Ditor DS, Tamim H, Gage WH. Supporting sexual adjustment from the perspective of men living with spinal cord injury. Spinal Cord. 2020;58(11):1176-1182. [DOI:10.1038/s41393-020-0479-6]
3. Del Popolo G, Cito G, Gemma L, Natali A. Neurogenic sexual dysfunction treatment: a systematic review. Eur Urol Focus. 2020;6(5):868-876. [DOI:10.1016/j.euf.2019.12.002]
4. Courtois F, Alexander M, McLain AB. Women's sexual health and reproductive function after SCI. Top Spinal Cord Inj Rehabil. 2017;23(1):20-30. [DOI:10.1310/sci2301-20]
5. Sramkova T, Skrivanova K, Dolan I, Zamecnik L, Sramkova K, Kriz J, et al. Women's sex life after spinal cord injury. Sex Med. 2017;5(4):e255-e259. [DOI:10.1016/j.esxm.2017.07.003]
6. Monga M, Bernie J, Rajasekaran M. Male infertility and erectile dysfunction in spinal cord injury: a review. Arch Phys Med Rehabil. 1999;80(10):1331-9. [DOI:10.1016/S0003-9993(99)90039-4]
7. Lue T. Physiology of penile erection and pathophysiology of erectile dysfunction. Campbell-Walsh Urology. 2007;1:688-719. [DOI:10.1016/B978-1-4160-6911-9.00023-2]
8. Alexander MS, Marson L. The neurologic control of arousal and orgasm with specific attention to spinal cord lesions: integrating preclinical and clinical sciences. Auton Neurosci. 2018;209:90-99. [DOI:10.1016/j.autneu.2017.01.005]
9. Anderson K, Borisoff J, Johnson R, Stiens S, Elliott S. The impact of spinal cord injury on sexual function: concerns of the general population. Spinal Cord. 2007;45(5):328-337. [DOI:10.1038/sj.sc.3101977]
10. Latella D, Maggio MG, Manuli A, Militi D, Calabrò RS. Sexual dysfunction in male individuals with spinal cord iniury: What do we know so far? J Clin Neurosci. 2019;68:20-27. [DOI:10.1016/j.jocn.2019.07.038]
11. Fode M, Krogh-Jespersen S, Brackett NL, Ohl DA, Lynne CM, Sønksen J. Male sexual dysfunction and infertility associated with neurological disorders. Asian J Androl. 2012;14(1):61-68. [DOI:10.1038/aja.2011.70]
12. Stoffel J, Van der Aa F, Wittmann D, Yande S, Elliott S. Fertility and sexuality in the spinal cord injury patient. World J Urol. 2018;36:1577-1585. [DOI:10.1007/s00345-018-2347-y]
13. Fenstermaker M, Dupree JM, Hadj-Moussa M, Ohl DA. Management of erectile dysfunction and infertility in the male spinal cord injury patient. Curr Urol Rep. 2018;19:1-5. [DOI:10.1007/s11934-018-0806-z]
14. Ohl DA, Quallich SA, Sønksen J, Brackett NL, Lynne CM. Anejaculation and retrograde ejaculation. Urol Clin North Am. 2008;35(2):211-220. [DOI:10.1016/j.ucl.2008.01.014]
15. Sinha V, Elliott S, Ibrahim E, Lynne CM, Brackett NL. Reproductive health of men with spinal cord injury. Top Spinal Cord Inj Rehabil. 2017;23(1):31-41. [DOI:10.1310/sci2301-31]
16. 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):2304-2308. [DOI:10.1016/j.juro.2010.02.018]
17. Ibrahim E, Lynne C, Brackett N. Male fertility following spinal cord injury: an update. Andrology. 2016;4(1):13-26. [DOI:10.1111/andr.12119]
18. Ghanem HM, Salonia A, Martin-Morales A. SOP: physical examination and laboratory testing for men with erectile dysfunction. J Sex Med. 2013;10(1):108-110. [DOI:10.1111/j.1743-6109.2012.02734.x]
19. Varela CG, Yeguas LAM, Rodríguez IC, Vila MDD. Penile Doppler ultrasound for erectile dysfunction: technique and interpretation. AJR Am J Roentgenol. 2020;214(5):1112-1121. [DOI:10.2214/AJR.19.22141]
20. Rosen RC, Cappelleri JC, Gendrano Nr. The International Index of Erectile Function (IIEF): a state-of-the-science review. Int J Impot Res. 2002;14(4):226-244. [DOI:10.1038/sj.ijir.3900857]
21. Yafi FA, Huynh LM, Ahlering T, Rosen R. What is a "validated questionnaire"? A critical review of erectile function assessment. The Journal of Sexual Medicine. 2020;17(5):849-860. [DOI:10.1016/j.jsxm.2020.02.005]
22. Ahuja CS, Wilson JR, Nori S, Kotter M, Druschel C, Curt A, et al. Traumatic spinal cord injury. Nat Rev Dis Primers. 2017;3:17018. [DOI:10.1038/nrdp.2017.18]
23. 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. 2021;39:953-962. [DOI:10.1007/s00345-020-03233-9]
24. Causanilles A, Cantillano DR, Emke E, Bade R, Baz-Lomba JA, Castiglioni S, et al. Comparison of phosphodiesterase type V inhibitors use in eight European cities through analysis of urban wastewater. Environ Int. 2018;115:279-284. [DOI:10.1016/j.envint.2018.03.039]
25. Chao R, Clowers DE. Experience with intracavernosal tri-mixture for the management of neurogenic erectile dysfunction. Arch Phys Med Rehabil. 1994;75(3):276-278. [DOI:10.1016/0003-9993(94)90028-0]
26. Kasum M, Orešković S, Kordić M, Čehić E, Hauptman D, Ejubović E, et al. Poboljšanje spolne i reprodukcijske funkcije u muškaraca s oštećenjem kralježnične moždine. Acta Clin Croat. 2018;57(1):149-156. [DOI:10.20471/acc.2018.57.01.19]
27. 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. Ann Neurol. 1999;46(1):15-21.
https://doi.org/10.1002/1531-8249(199907)46:1<15::AID-ANA5>3.0.CO;2-U [DOI:10.1002/1531-8249(199907)46:13.0.CO;2-U]
28. Hultling C, Giuliano F, Quirk F, Pena B, Mishra A, Smith M. Quality of life in patients with spinal cord injury receiving VIAGRA®(sildenafil citrate) for the treatment of erectile dysfunction. Spinal Cord. 2000;38(6):363-370. [DOI:10.1038/sj.sc.3101011]
29. Derry F, Dinsmore W, Fraser M, Gardner B, Glass C, Maytom M, et al. Efficacy and safety of oral sildenafil (Viagra) in men with erectile dysfunction caused by spinal cord injury. Neurology. 1998;51(6):1629-1633. [DOI:10.1212/WNL.51.6.1629]
30. Sanchez Ramos A, Vidal J, Jauregui M, 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):637-643. [DOI:10.1038/sj.sc.3101210]
31. 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):709-715. [DOI:10.1097/BRS.0b013e3181695040]
32. Denil J, Ohl DA, Smythe C. Vacuum erection device in spinal cord injured men: patient and partner satisfaction. Arch Phys Med Rehabil. 1996;77(8):750-753. [DOI:10.1016/S0003-9993(96)90252-X]
33. Rivas DA, Chancellor MB. Complications associated with the use of vacuum constriction devices for erectile dysfunction in the spinal cord injured population. J Am Paraplegia Soc. 1994;17(3):136-9. [DOI:10.1080/01952307.1994.11735923]
34. Lim CA, 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. [DOI:10.1038/s41393-019-0404-z]
35. Jeyathevan G, Cameron JI, Craven BC, Munce SE, Jaglal SB. Re-building relationships after a spinal cord injury: experiences of family caregivers and care recipients. BMC Neurol. 2019;19(1):117. [DOI:10.1186/s12883-019-1347-x]
36. Morin EC. Americans with Disabilities Act of 1990: Social integration through employment. Cath UL Rev. 1990;40:189.
37. Di Bello F, Creta M, Napolitano L, Califano G, Passaro F, Morra S, et al. Male sexual dysfunction and infertility in spinal cord injury patients: state-of-the-art and future perspectives. J Pers Med. 2022;12(6):873. [DOI:10.3390/jpm12060873]
38. Thomas C, Konstantinidis C. Neurogenic erectile dysfunction. where do we stand? Medicines. 2021;8(1):3. [DOI:10.3390/medicines8010003]
39. Teplitsky S, Murphy A, Shenot PJ. Knowledge gaps in urologic care of female spinal cord injury patients. Curr Urol Rep. 2019;20(5):21. [DOI:10.1007/s11934-019-0884-6]
40. Faubion SS, Rullo JE. Sexual dysfunction in women: a practical approach. Am Fam Physician. 2015;92(4):281-288.
41. Clayton AH, Juarez EMV. Female sexual dysfunction. Med Clin North Am. 2019;103(4):681-698. 42. [DOI:10.1016/j.mcna.2019.02.008]
42. Alexander MS, Aisen CM, Alexander SM, Aisen ML. Sexual concerns after Spinal Cord Injury: An update on management. NeuroRehabilitation. 2017;41(2):343-357. [DOI:10.3233/NRE-172202]
43. Hajiaghababaei M, Javidan A, Saberi H, Khoei E, Khalifa D, Koenig H, et al. Female sexual dysfunction in patients with spinal cord injury: a study from Iran. Spinal Cord. 2014;52(8):646-649. [DOI:10.1038/sc.2014.99]
44. D'Andrea S, Castellini C, Paladino V, Totaro M, Felzani G, Francavilla S, Francavilla F, Barbonetti A. Metabolic syndrome is the key determinant of impaired vaginal lubrication in women with chronic spinal cord injury. J Endocrinol Invest. 2020;43(7):1001-1007. [DOI:10.1007/s40618-020-01185-w]
45. Celik E, Akman Y, Kose P, Arioglu P, Karatas M, Erhan B. Sexual problems of women with spinal cord injury in Turkey. Spinal Cord. 2014;52(4):313-315. [DOI:10.1038/sc.2013.161]
46. Elliott S. Sexual dysfunction and infertility in men with spinal cord disorders. Spinal Cord Medicine: Principles and Practice New York: Demos Medical Publishing. 2003:349-365.
47. Alexander MS, Brackett NL, Bodner D, Elliott S, Jackson A, Sonksen J. Measurement of sexual functioning after spinal cord injury: preferred instruments: report of the National Institute on Disability and Rehabilitation Research Spinal Cord Injury Measures Meeting. J Spinal Cord Med. 2009;32(3):226-236. 48. Gao Z, Yang D, Yu L, Cui Y. Efficacy and safety of flibanserin in women with hypoactive sexual desire disorder: a systematic review and meta-analysis. J Sex Med. 2015;12(11):2095-104. [DOI:10.1111/jsm.13037]
48. 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.
49. Alexander M, Bashir K, Alexander C, Marson L, Rosen R. Randomized trial of clitoral vacuum suction versus vibratory stimulation in neurogenic female orgasmic dysfunction. Arch Phys Med Rehabil. 2018;99(2):299-305. [DOI:10.1016/j.apmr.2017.09.001]
50. Alexander M, Courtois F, Elliott S, Tepper M. Improving Sexual Satisfaction in Persons with Spinal Cord Injuries: Collective Wisdom. Top Spinal Cord Inj Rehabil. 2017;23(1):57-70. [DOI:10.1310/sci2301-57]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Attribution-NoneCommercial CC BY-NC
