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Taylan S, Gözüyeşil E, Manav Aİ, Işık Eİ. An evaluation of the factors that affect the sexual satisfaction of people with spinal cord injuries. J Spinal Cord Med 2021; 44:590-597. [PMID: 31603386 PMCID: PMC8288136 DOI: 10.1080/10790268.2019.1672955] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Objective: To evaluate the relationships between the variables that affect the sexual satisfaction of patients with spinal cord injuries.Design: Descriptive and cross-sectional survey.Setting: The physical medicine and rehabilitation outpatient clinic of a university hospital in Turkey.Participants: This study was performed from July to December2018. It included 103 patients with spinal cord injuries.Outcome Measures: The data were collected using an introductory information form, the American Spinal Injury Association Impairment Scale and the Golombok Rust Inventory of Sexual Satisfaction. Data were evaluated using the chi-square test, the Mann-Whitney U test, the Kruskal-Wallis test and linear regression.Results: The total mean scores on the Golombok Rust Inventory of Sexual Satisfaction were 40.2 ± 21.6 for males and 44.9 ± 18.1 for females. According to the linear regression analysis, model VII presented the best results of the relationship between physiological and psychological determinants that affect the sexual satisfaction of patients with spinal cord injuries. Model VII consisted of the variables of ASIA A and B scores, age, injury due to falling from height, being a housewife, and thinking of being unable to reach future goals. These explained 75.4% of the variation in sexual satisfaction scores.Conclusion: The participants' mean scores on the Golombok Rust Inventory of Sexual Satisfaction were found to be affected by various variables. A significant relationship between their mean scores on the American Spinal Injury Association (ASIA) Impairment Scale and the Golombok Rust Inventory of Sexual Satisfaction was determined.
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Affiliation(s)
- Seçil Taylan
- Kumluca Faculty of Health Sciences, Surgical Nursing Department, Akdeniz University, Kumluca-Antalya, Turkey
| | - Ebru Gözüyeşil
- Faculty of Health Sciences, Nursing Department, Osmaniye Korkut Ata University, Osmaniye, Turkey
| | - Ayşe İnel Manav
- Faculty of Health Sciences, Nursing Department, Osmaniye Korkut Ata University, Osmaniye, Turkey
| | - Emir İbrahim Işık
- Therapy and Rehabılıtatıon Department, Vocatıonal School of Health Servıces, Cukurova University, Adana, Turkey
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Denys P, Chartier-Kastler E, Even A, Joussain C. How to treat neurogenic bladder and sexual dysfunction after spinal cord lesion. Rev Neurol (Paris) 2021; 177:589-593. [PMID: 33610350 DOI: 10.1016/j.neurol.2020.07.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/06/2020] [Indexed: 01/09/2023]
Abstract
Neurogenic bladder and sexual dysfunction after spinal cord lesions are highly prevalent. The treatment algorithm for neurogenic bladder is well described. Clean intermittent self-catheterisation associated with treatment of neurogenic detrusor overactivity is the gold standard. Goals of treatment are twofold: i) control risk factors to avoid upper urinary tract complications, and ii) improve quality of life by treating incontinence when feasible. Lower urinary tract dysfunction is still a major cause of complications and hospitalisation. Sexual dysfunction must be addressed and treated and is at the top of patient expectations one year after injury.
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Affiliation(s)
- P Denys
- Neurourology and andrology unit, department of physical medecine and rehabilitation, Raymond-Poincaré Hospital AP-HP; Université Paris-Saclay; UMR 1179 Inserm, Paris, France.
| | - E Chartier-Kastler
- Department of urology, Hôpital de la Pitié, Paris-Sorbonne Université, Paris, France
| | - A Even
- Neurourology and andrology unit, department of physical medecine and rehabilitation, Raymond-Poincaré Hospital AP-HP; Université Paris-Saclay; UMR 1179 Inserm, Paris, France
| | - C Joussain
- Neurourology and andrology unit, department of physical medecine and rehabilitation, Raymond-Poincaré Hospital AP-HP; Université Paris-Saclay; UMR 1179 Inserm, Paris, France
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3
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Sexual Health in the Neurogenic Patient. CURRENT BLADDER DYSFUNCTION REPORTS 2020. [DOI: 10.1007/s11884-020-00605-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Del Popolo G, Cito G, Gemma L, Natali A. Neurogenic Sexual Dysfunction Treatment: A Systematic Review. Eur Urol Focus 2020; 6:868-876. [DOI: 10.1016/j.euf.2019.12.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 11/11/2019] [Accepted: 12/10/2019] [Indexed: 11/26/2022]
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5
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The Effect of Exercise on Sexual Satisfaction and Sexual Interest for Individuals with Spinal Cord Injury. SEXUALITY AND DISABILITY 2020. [DOI: 10.1007/s11195-020-09654-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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6
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Babany F, Coindreau V, Declémy A, Savard E, Charlanes A, Chesnel C, Amarenco G. [Female orgasm during neurological disorders]. Prog Urol 2020; 30:554-570. [PMID: 32417173 DOI: 10.1016/j.purol.2020.04.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Sexual dysfunctions, particularly orgasm dysfunction, were not routinely assessed in daily practice in neurological women. OBJECTIVE To assess type, frequency and impact of neurological women orgasm dysfunction. METHOD A systematic review was conducted with Medline via Pubmed and The Cochrane Database of Systematic Review. RESULTS Neurological women's orgasm dysfunction is poorly assessed. The most of these were clinical small retrospective studies assessed by general questionnaires and some with electrophysiological assessments. Multiple sclerosis (MS) and Spinal cord injury (SCI) were the two most studied conditions. Orgasm dysfunction is observed in one third of neurological women, associated with arousal troubles, voiding and anal dysfunction. Orgasm alteration seriously impact quality of life of these patients. CONCLUSION Specific studies could be conducted in this specific field in order to increase quality of life of these neurogenic patients suffered from such sexual dysfunction.
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Affiliation(s)
- F Babany
- GREEN, groupe de recherche clinique en neuro-urologie, Sorbonne université, GRC 01, hôpital Tenon, AP-HP, 75020 Paris, France.
| | - V Coindreau
- GREEN, groupe de recherche clinique en neuro-urologie, Sorbonne université, GRC 01, hôpital Tenon, AP-HP, 75020 Paris, France
| | - A Declémy
- GREEN, groupe de recherche clinique en neuro-urologie, Sorbonne université, GRC 01, hôpital Tenon, AP-HP, 75020 Paris, France
| | - E Savard
- GREEN, groupe de recherche clinique en neuro-urologie, Sorbonne université, GRC 01, hôpital Tenon, AP-HP, 75020 Paris, France
| | - A Charlanes
- GREEN, groupe de recherche clinique en neuro-urologie, Sorbonne université, GRC 01, hôpital Tenon, AP-HP, 75020 Paris, France
| | - C Chesnel
- GREEN, groupe de recherche clinique en neuro-urologie, Sorbonne université, GRC 01, hôpital Tenon, AP-HP, 75020 Paris, France
| | - G Amarenco
- GREEN, groupe de recherche clinique en neuro-urologie, Sorbonne université, GRC 01, hôpital Tenon, AP-HP, 75020 Paris, France
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Wiggins JW, Kozyrev N, Sledd JE, Wilson GG, Coolen LM. Chronic Spinal Cord Injury Reduces Gastrin-Releasing Peptide in the Spinal Ejaculation Generator in Male Rats. J Neurotrauma 2019; 36:3378-3393. [PMID: 31111794 DOI: 10.1089/neu.2019.6509] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Spinal cord injury (SCI) causes sexual dysfunction, including anejaculation in men. Likewise, chronic mid-thoracic contusion injury impairs ejaculatory reflexes in male rats. Ejaculation is controlled by a spinal ejaculation generator (SEG) comprised of a population of lumbar spinothalamic (LSt) neurons. LSt neurons co-express four neuropeptides, including gastrin-releasing peptide (GRP) and galanin and control ejaculation via release of these peptides in lumbar and sacral autonomic and motor nuclei. Here, we tested the hypothesis that contusion injury causes a disruption of the neuropeptides that are expressed in LSt cell bodies and axon terminals, thereby causing ejaculatory dysfunction. Male Sprague Dawley rats received contusion or sham surgery at spinal levels T6-7. Five to six weeks later, animals were perfused and spinal cords were immunoprocessed for galanin and GRP. Results showed that numbers of cells immunoreactive for galanin were not altered by SCI, suggesting that LSt cells are not ablated by SCI. In contrast, GRP immunoreactivity was decreased in LSt cells following SCI, evidenced by fewer GRP and galanin/GRP dual labeled cells. However, SCI did not affect efferent connections of LSt, cells as axon terminals containing galanin or GRP in contact with autonomic cells were not reduced following SCI. Finally, no changes in testosterone plasma levels or androgen receptor expression were noted after SCI. In conclusion, chronic contusion injury decreased immunoreactivity for GRP in LSt cell soma, but did not affect LSt neurons per se or LSt connections within the SEG. Since GRP is essential for triggering ejaculation, such loss may contribute to ejaculatory dysfunction following SCI.
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Affiliation(s)
- J Walker Wiggins
- Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, Mississippi.,Graduate Program in Neuroscience, University of Mississippi Medical Center, Jackson, Mississippi
| | - Natalie Kozyrev
- Robarts Institute, Western University, London, Ontario, Canada
| | - Jonathan E Sledd
- Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, Mississippi
| | - George G Wilson
- Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, Mississippi
| | - Lique M Coolen
- Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, Mississippi.,Department of Biological Sciences, Kent State University, Kent, Ohio
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Park SE, Elliott S, Noonan VK, Thorogood NP, Fallah N, Aludino A, Dvorak MF. Impact of bladder, bowel and sexual dysfunction on health status of people with thoracolumbar spinal cord injuries living in the community. J Spinal Cord Med 2017; 40:548-559. [PMID: 27576584 PMCID: PMC5815154 DOI: 10.1080/10790268.2016.1213554] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE The disruption of autonomic function following a spinal cord injury (SCI) is common and can negatively affect quality of life. The objective of this study was to describe the prevalence of bladder/bowel incontinence and sexual dysfunction in community-dwelling individuals with a thoracolumbar SCI and examine the impact on general physical and mental health status. METHODS Participants who sustained a traumatic SCI to the thoracolumbar region of the spinal cord and classified as American Spinal Injury Association Impairment Scale (AIS) A to D were recruited. Demographic, injury data, MRI classification and neurological data were collected on admission. At follow-up, the neurological data, a questionnaire collecting participant-reported secondary health conditions (SHCs) (e.g. bladder incontinence, depression etc.) following SCI and health status measured by Short Form-36 were obtained. Regression models determined the association of health status with demographic/injury-related data, types and number of SHCs. RESULTS Of the 51 participants, 58.8% reported bladder incontinence, 54.0% bowel incontinence, 60.8% sexual dysfunction and 29.4% had all three. The regression models demonstrated that age at injury, bowel incontinence, sexual dysfunction, presence of pain, motor score at follow-up and the number of SHCs were significant predictors of health status. The number of SHCs was more predictive than all other demographic and injury variables for health status. CONCLUSION Results highlight the high prevalence of self-reported bowel/bladder incontinence and sexual dysfunction in the traumatic thoracolumbar SCI population and support the need for standardized assessments. Several demographic, injury-related and SHCs impacted health status and should be considered for the management of individuals living in the community.
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Affiliation(s)
| | - Stacy Elliott
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada,Urologic Sciences, University of British Columbia, Vancouver, BC, Canada,International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada,Vancouver Sperm Retrieval Clinic, Vancouver Coastal Health Authority, Vancouver, BC, Canada,G.F. Strong Rehabilitation Center, Sexual Health Rehabilitation Service, Vancouver, BC, Canada
| | - Vanessa K. Noonan
- Rick Hansen Institute, Vancouver, BC, Canada,Division of Spine, Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada,Correspondence to: Vanessa Noonan, Research and Best Practice Implementation, Rick Hansen Institute, 6th Floor, Blusson Spinal Cord Centre, 6400 - 818 W. 10th Avenue, Vancouver, British Columbia, Canada V5Z 1M9.
| | | | - Nader Fallah
- Rick Hansen Institute, Vancouver, BC, Canada,Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Allan Aludino
- Division of Spine, Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada,Vancouver Spine Surgery Institute, Vancouver General Hospital, Vancouver, BC, Canada
| | - Marcel F. Dvorak
- Division of Spine, Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada,Vancouver Spine Surgery Institute, Vancouver General Hospital, Vancouver, BC, Canada
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Stamatiou K, Margariti M, Nousi E, Mistrioti D, Lacroix R, Saridi M. FEMALE SEXUAL DYSFUNCTION (FSD) IN WOMEN HEALTH CARE WORKERS. Mater Sociomed 2016; 28:178-82. [PMID: 27482157 PMCID: PMC4949039 DOI: 10.5455/msm.2016.28.178-182] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 04/15/2016] [Indexed: 01/23/2023] Open
Abstract
PURPOSE The main aim of this study is to investigate the occurrence and severity of FSD in women working in tertiary hospitals. MATERIAL AND METHODS The study sample was drawn from health care women between the ages of 20 and 65 years, working in two hospitals in Greece. This descriptive study used a structured Greek questionnaire and sexual function screener and quality of life sectors were consisted of rated scale questions. Eighty eight questionnaires were returned properly completed. The statistical analysis used the SPSS statistical program. RESULTS Female sexual dysfunction is a highly prevalent health issue whose exact incidence is not well defined. Factors that can contribute to female sexual dysfunction may be psychogenic, physical, mixed or unknown. Each of these factors consists of individual components that influence the sexual response; however their precise impact in FSD development and progression is unknown. Moreover, the role of circadian rhythm disorders (especially that of shift work sleep disorder) to the development and progression of FSD has been poorly investigated. CONCLUSION Working environment and patterns of work schedules may play a role in FSD however it has been difficult to specify in what extent they contribute to FSD development.
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Affiliation(s)
| | - Maria Margariti
- Nursing Department, Tzaneio General Hospital of Piraeus, Greece
| | - Eftichia Nousi
- Nursing Department, Tzaneio General Hospital of Piraeus, Greece
| | | | - Richard Lacroix
- University of Piraeus, Department of Management and Technology, Greece
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Steadman CJ, Hubscher CH. Sexual Function after Spinal Cord Injury: Innervation, Assessment, and Treatment. CURRENT SEXUAL HEALTH REPORTS 2016. [DOI: 10.1007/s11930-016-0067-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Sociodemographic factors associated with sexual dysfunction in Mexican women with spinal cord injury. Spinal Cord 2016; 54:746-9. [PMID: 26902463 DOI: 10.1038/sc.2016.19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 01/12/2016] [Accepted: 01/14/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVES No studies have reported sexual dysfunction in Mexican women with a spinal cord injury (SCI).The objective of the present study was to determine the association between sociodemographic factors and sexual dysfunction characteristics in Mexican females with SCI. METHODS An observational, cross-sectional, descriptive study was conducted in different rehabilitation centers in Mexico City from July 2013 to November 2014. Adult females with a SCI without any gynecologic structural abnormalities, which by itself produced sexual dysfunction, were included. The Female Sexual Function Index (FSFI) was answered personally by all participants. Other variables such as AIS (American spinal injury association Impairment Scale), neurologic level, time since injury, age, relationship status, socioeconomic status, spasticity, use of antispasticity drugs, education level, antidepressant medication, Spinal Cord Independence Measure III score, offspring, work activities and neuropathic pain were considered. RESULTS There is a high percentage of sexual dysfunction among Mexican woman with SCI (81.9%). Age range went from 18- to 78-year old (42.8±15.87-year old). Time since injury went from 2 to 708 months (65.16±117.65 months). The study showed a negative correlation between age and the FSFI questionnaire (correlation coefficient (CC)=-0.384, P<0.001).There was no significant difference between the means (analysis of variance) of the different groups for neurologic level, socioeconomic status, spasticity and education level. CONCLUSION Results showed that the younger the person is, the better sexual function they have, and offspring decreased sexual function and work activities increased it. Some variables showed small comparative groups (use of antidepressives/antispastics and comorbilities), which may be the reason we could not see significative differences in the means.
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Russell HF, Richardson EJ, Bombardier CH, Dixon TM, Huston TA, Rose J, Sheaffer D, Smith SA, Ullrich PM. Professional standards of practice for psychologists, social workers, and counselors in SCI rehabilitation. J Spinal Cord Med 2015; 39:127-45. [PMID: 26707599 PMCID: PMC5072492 DOI: 10.1080/10790268.2015.1119966] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
| | - Elizabeth J. Richardson
- Department of Physical Medicine & Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | | | - Jon Rose
- VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Dawn Sheaffer
- Shriners Hospitals for Children, Philadelphia, PA, USA
| | | | - Philip M. Ullrich
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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Lombardi G, Musco S, Kessler TM, Marzi VL, Lanciotti M, Del Popolo G. Management of sexual dysfunction due to central nervous system disorders: a systematic review. BJU Int 2015; 115 Suppl 6:47-56. [DOI: 10.1111/bju.13055] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Giuseppe Lombardi
- Neuro-Urology Department; Careggi University Hospital; Florence Italy
| | - Stefania Musco
- Neuro-Urology Department; Careggi University Hospital; Florence Italy
| | - Thomas M. Kessler
- Neuro-Urology; Spinal Cord Injury Center and Research; Balgrist University Hospital; University of Zürich; Zürich Switzerland
| | | | | | - Giulio Del Popolo
- Neuro-Urology Department; Careggi University Hospital; Florence Italy
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Denys P, Soler JM, Giuliano F. Sexualité du patient neurologique. Prog Urol 2013; 23:712-7. [DOI: 10.1016/j.purol.2013.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 01/12/2013] [Accepted: 01/14/2013] [Indexed: 10/27/2022]
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Borisoff JF, Elliott SL, Hocaloski S, Birch GE. The development of a sensory substitution system for the sexual rehabilitation of men with chronic spinal cord injury. J Sex Med 2010; 7:3647-58. [PMID: 20807328 DOI: 10.1111/j.1743-6109.2010.01997.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Sexual health is often severely impacted after spinal cord injury (SCI). Current research has primarily addressed male erection and fertility, when in fact pleasure and orgasm are top priorities for functional recovery. Sensory substitution technology operates by communicating input from a lost sensory pathway to another intact sensory modality. It was hypothesized that through training and neuroplasticity, mapped tongue sensations would be interpreted as sensory perceptions arising from insensate genitalia, and improve the sexual experience. AIM To report the development of a sensory substitution system for the sexual rehabilitation of men with chronic SCI. METHODS Subjects performed sexual self-stimulation while using a novel sensory substitution device that mapped the stroking motion of the hand to a congruous flow of electrocutaneous sensations on the tongue. MAIN OUTCOME MEASURES Three questionnaires, along with structured interviews, were used to rate the perceived sexual sensations following each training session. RESULTS Subjects completed 20 sessions over approximately 8 weeks of training. Each subject reported an increased level of sexual pleasure soon after training with the device. Each subject also reported specific perceptions of cutaneous-like sensations below their lesion that matched their hand motion. Later sessions, while remaining pleasurable and interesting, were inconsistent, and no subject reported an orgasmic feeling during a session. The subjects were all interested in continuing training with the device at home, if possible, in the future. CONCLUSIONS This study is the first to show that sensory substitution is a possible therapeutic avenue for sexual rehabilitation in people lacking normal genital sexual sensations. However more research, for instance on frequency and duration of training, is needed in order to induce functional lasting neuroplasticity. In the near term, SCI rehabilitation should more fully address sexuality and the role of neuroplasticity for promoting the maximal potential for sexual pleasure and orgasm.
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Nosek MA, Hughes RB, Robinson-Whelen S. The complex array of antecedents of depression in women with physical disabilities: Implications for clinicians. Disabil Rehabil 2009; 30:174-83. [PMID: 17852240 DOI: 10.1080/09638280701532219] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE This article discusses the complex interrelation of elements of the physical, psychological, social, and environmental life context of women with physical disabilities and the association of these elements with significant disparities in rates of depression and access to mental health care for this population. METHODS Literature and concept review. RESULTS High rates of depression in women with physical disabilities are well documented in the literature. Many elements that are disproportionately common in the lives of women with physical disabilities, including socio-economic disadvantage, functional limitations, pain and other chronic health conditions, poor diet, physical inactivity, smoking, violence, low self-esteem, sexuality problems, chronic stress, environmental barriers, and barriers to health care, have also been linked with higher rates of depression and depressive symptomatology. Depression self-management interventions tailored for women with disabilities have been developed and proven effective. CONCLUSIONS Many women who must deal with the stresses surrounding an array of health problems may experience symptoms of depression without necessarily meeting the criteria for clinical depression. Psychologists, counselors, primary care physicians, specialists, and other medical and rehabilitation professionals are challenged to recognize the symptoms of depression in women with physical disabilities and assist them in obtaining appropriate psychological and pharmacological interventions.
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Affiliation(s)
- Margaret A Nosek
- Center for Research on Women with Disabilities, Baylor College of Medicine, PO Box 890286, Houston, Texas 77289, USA.
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Krassioukov A, Warburton DER, Teasell R, Eng JJ. A systematic review of the management of autonomic dysreflexia after spinal cord injury. Arch Phys Med Rehabil 2009; 90:682-95. [PMID: 19345787 PMCID: PMC3108991 DOI: 10.1016/j.apmr.2008.10.017] [Citation(s) in RCA: 238] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Revised: 07/25/2008] [Accepted: 10/06/2008] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To review systematically the clinical evidence on strategies to prevent and manage autonomic dysreflexia (AD). DATA SOURCES A key word search of several databases (Medline, CINAHL, EMBASE, and PsycINFO), in addition to manual searches of retrieved articles, was undertaken to identify all English-language literature evaluating the efficacy of interventions for AD. STUDY SELECTION Studies selected for review included randomized controlled trials (RCTs), prospective cohort studies, and cross-sectional studies. Treatments reviewed included pharmacologic and nonpharmacologic interventions for the management of AD in subjects with spinal cord injury. Studies that failed to assess AD outcomes (eg, blood pressure) or symptoms (eg, headaches, sweating) were excluded. DATA EXTRACTION Studies were critically reviewed and assessed for their methodologic quality by 2 independent reviewers. DATA SYNTHESIS Thirty-one studies were assessed, including 6 RCTs. Preventative strategies to reduce the episodes of AD caused by common triggers (eg, urogenital system, surgery) primarily were supported by level 4 (pre-post studies) and level 5 (observational studies) evidence. The initial acute nonpharmacologic management of an episode of AD (ie, positioning the patient upright, loosening tight clothing, eliminating any precipitating stimulus) is supported by clinical consensus and physiologic data (level 5 evidence). The use of antihypertensive drugs in the presence of sustained elevated blood pressure is supported by level 1 (prazosin) and level 2 evidence (nifedipine and prostaglandin E(2)). CONCLUSIONS A variety of options are available to prevent AD (eg, surgical, pharmacologic) and manage the acute episode (elimination of triggers, pharmacologic); however, these options are predominantly supported by evidence from noncontrolled trials, and more rigorous trials are required.
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Affiliation(s)
- Andrei Krassioukov
- International Collaboration on Repair Discoveries (ICORD)
- Division of Physical Medicine and Rehabilitation, University of BC, Vancouver, Canada
- Department of Physical Therapy, University of BC, Vancouver, Canada
| | - Darren ER Warburton
- International Collaboration on Repair Discoveries (ICORD)
- Cardiovascular Physiology and Rehabilitation Laboratory & Experimental Medicine, University of BC, Vancouver, Canada
| | - Robert Teasell
- Department of Physical Medicine & Rehabilitation, University of Western Ontario, London, ON, Canada
| | - Janice J Eng
- International Collaboration on Repair Discoveries (ICORD)
- Department of Physical Therapy, University of BC, Vancouver, Canada
- Rehabilitation Research Laboratory, GF Strong Rehab Centre, Vancouver, Canada
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International standards to document remaining autonomic function after spinal cord injury. Spinal Cord 2008; 47:36-43. [PMID: 18957962 DOI: 10.1038/sc.2008.121] [Citation(s) in RCA: 188] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
STUDY DESIGN Experts opinions consensus. OBJECTIVE To develop a common strategy to document remaining autonomic neurologic function following spinal cord injury (SCI). BACKGROUND AND RATIONALE The impact of a specific SCI on a person's neurologic function is generally described through use of the International Standards for the Neurological Classification of SCI. These standards document the remaining motor and sensory function that a person may have; however, they do not provide information about the status of a person's autonomic function. METHODS Based on this deficiency, the American Spinal Injury Association (ASIA) and the International Spinal Cord Society (ISCoS) commissioned a group of international experts to develop a common strategy to document the remaining autonomic neurologic function. RESULTS Four subgroups were commissioned: bladder, bowel, sexual function and general autonomic function. On-line communication was followed by numerous face to face meetings. The information was then presented in a summary format at a course on Measurement in Spinal Cord Injury, held on June 24, 2006. Subsequent to this it was revised online by the committee members, posted on the websites of both ASIA and ISCoS for comment and re-revised through webcasts. Topics include an overview of autonomic anatomy, classification of cardiovascular, respiratory, sudomotor and thermoregulatory function, bladder, bowel and sexual function. CONCLUSION This document describes a new system to document the impact of SCI on autonomic function. Based upon current knowledge of the neuroanatomy of autonomic function this paper provides a framework with which to communicate the effects of specific spinal cord injuries on cardiovascular, broncho-pulmonary, sudomotor, bladder, bowel and sexual function.
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Inskip JA, Ramer LM, Ramer MS, Krassioukov AV. Autonomic assessment of animals with spinal cord injury: tools, techniques and translation. Spinal Cord 2008; 47:2-35. [DOI: 10.1038/sc.2008.61] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Ricciardi R, Szabo CM, Poullos AY. Sexuality and Spinal Cord Injury. Nurs Clin North Am 2007; 42:675-84; viii-ix. [DOI: 10.1016/j.cnur.2007.08.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Abstract
Common in the medically ill, sexual dysfunction results from disruption of one or more stages of the sexual response cycle. Increased understanding of sexual pathophysiology and the psychosocial forces whereby diseases impede normal function promotes more informed treatment choices. This review focuses on the pathophysiology, impact, and treatment options of sexual dysfunction in men and women with spinal cord injuries, multiple sclerosis, dementia, hypertension, heart disease, stroke, cancer, and HIV/AIDS.
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Bianchi-Demicheli F, Ortigue S. Toward an understanding of the cerebral substrates of woman's orgasm. Neuropsychologia 2007; 45:2645-59. [PMID: 17543356 DOI: 10.1016/j.neuropsychologia.2007.04.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2006] [Revised: 04/07/2007] [Accepted: 04/13/2007] [Indexed: 01/29/2023]
Abstract
The way women experience orgasm is of interest to scientists, clinicians, and laypeople. Whereas the origin and the function of a woman's orgasm remains controversial, the current models of sexual function acknowledge a combined role of central (spinal and cerebral) and peripheral processes during orgasm experience. At the central level, although it is accepted that the spinal cord drives orgasm, the cerebral involvement and cognitive representation of a woman's orgasm has not been extensively investigated. Important gaps in our knowledge remain. Recently, the astonishing advances of neuroimaging techniques applied in parallel with a neuropsychological approach allowed the unravelling of specific functional neuroanatomy of a woman's orgasm. Here, clinical and experimental findings on the cortico-subcortical pathway of a woman's orgasm are reviewed and compared with the neural basis of a man's orgasm. By defining the specific brain areas that sustain the assumed higher-order representation of a woman's orgasm, this review provides a foundation for future studies. The next challenge of functional imaging and neuropsychological studies is to understand the hierarchical interactions between these multiple cortical areas, not only with a correlation analysis but also with high spatio-temporal resolution techniques demonstrating the causal necessity, the temporal time course and the direction of the causality. Further studies using a multi-disciplinary approach are needed to identify the spatio-temporal dynamic of a woman's orgasm, its dysfunctions and possible new treatments.
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Affiliation(s)
- Francesco Bianchi-Demicheli
- Psychosomatic Gynaecology and Sexology Unit, Emergency and Liaison Services, Geneva University Psychiatric Centre, Switzerland
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Anderson KD, Borisoff JF, Johnson RD, Stiens SA, Elliott SL. Spinal cord injury influences psychogenic as well as physical components of female sexual ability. Spinal Cord 2006; 45:349-59. [PMID: 17033619 DOI: 10.1038/sj.sc.3101979] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Secure, web-based survey. OBJECTIVES Elicit specific information about sexual function from women with spinal cord injuries (SCI). SETTING World-wide web. METHODS Individuals 18 years or older living with SCI obtained a pass code to enter a secure website and then answered survey questions. RESULTS Bladder and/or bowel incontinence during sexual activity and/or sexual intercourse were significant concerns and prevented some women from seeking sexual activity. Autonomic dysreflexia (AD) during sexual activity was interpreted negatively by many and was found to interfere with sexual activity. Most subjects reported difficulty becoming psychologically aroused as well as physically aroused, which were both correlated with feeling that their SCI had altered their sexual sense of self. An inverse relationship existed between developing new areas of arousal above the level of lesion and not having sensation or movement below the lesion. The most commonly reported sexual stimulation leading to the best arousal involved stimulation of the head/neck and torso areas. The majority of subjects reported having experienced intercourse postinjury. Most participants reported difficulty with positioning during foreplay and intercourse, vaginal lubrication, and spasticity during intercourse. Almost half reported experiencing orgasm postinjury and this was positively associated with the presence of genital sensation. CONCLUSION SCI significantly impairs psychological and physical aspects of female sexual arousal. In addition, bladder and bowel incontinence as well as AD negatively impact sexual activity and intercourse.
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Affiliation(s)
- K D Anderson
- Department of Neurological Surgery, Reeve-Irvine Research Center, University of California, Irvine, CA 92697, USA
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