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Taylan S, Özkan İ, Kolaç N. Dyadic adjustment and the relationship between sexual self-consciousness and sexual dysfunction in individuals with spinal cord injuries: A descriptive study. J Spinal Cord Med 2024; 47:79-90. [PMID: 36441021 PMCID: PMC10795650 DOI: 10.1080/10790268.2022.2135732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study was conducted to determine the dyadic adjustment between individuals with SCI and their spouses and the relationship between their sexual self-consciousness and sexual life and to evaluate it according to the objectification theory. METHOD This descriptive and cross-sectional study was conducted with 131 married individuals with SCI registered in the physical therapy and rehabilitation outpatient clinic of a university hospital between February 2020 and April 2021. The data of the study were collected using a Descriptive Information Form, the American Spinal Injury Association Impairment Scale (ASIA), the Dyadic Adjustment Scale (DAS), the Sexual Self-Consciousness Scale (SSCS), and the Arizona Sexual Experiences Scale (ASEX). In the study, the predictors of the sexual life of individuals with SCI were evaluated with the Stepwise Multiple Linear Regression analysis. In addition, predictors of sexual dysfunction in individuals with SCI were evaluated by the logistic regression analysis. The results were discussed within the framework of objectification theory. RESULTS According to the results of the study, .67.2% of the individuals with spinal cord injuries experienced sexual functionality problems; increased age, falling injuries, and being in ASIA grade A increased sexual self-awareness and sexual dysfunction; and being a male with SCI increased sexual focus. It was found that the adjustment between individuals with SCI and their spouses was a predictor that significantly reduced sexual embarrassment, sexual self-consciousness, and sexual dysfunction and that the strong adjustment between couples was an important factor for the prevention of sexual dysfunction development. CONCLUSION It was found that most individuals with spinal cord injuries experienced sexual dysfunction. The importance of dyadic adjustment and sexual self-consciousness has come to the fore in the sexual life of these individuals.
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Affiliation(s)
- Seçil Taylan
- Kumluca Faculty of Health Sciences, Surgical Nursing Department, Akdeniz University, Kumluca-Antalya, Turkey
| | - İlknur Özkan
- Kumluca Faculty of Health Sciences, Surgical Nursing Department, Akdeniz University, Kumluca-Antalya, Turkey
| | - Nurcan Kolaç
- Marmara Üniversitesi Hemşirelik Fakültesi, Istanbul
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Acosta-Santillán PL, Toro-Sashida MF, Rosas-Mendoza AV, Fuentes-Orozco C, Jasso-García K, García de León-Flores P, Mellado-Téllez MP, Ibarra-Camargo SA, Chejfec-Ciociano JM, Barbosa-Camacho FJ, Flores-Prado JA, Cervantes-Guevara G, Cervantes-Pérez E, Cevantes-Cardona GA, Alvarez-Villaseñor AS, González-Ojeda A. Quality of sexual life in Mexican men after spinal cord injury. J Rehabil Med 2023; 55:jrm11641. [PMID: 38124428 PMCID: PMC10802783 DOI: 10.2340/jrm.v55.11641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 10/24/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE To evaluate the quality of sexual life in men with spinal cord injury. DESIGN Cross-sectional analytical study. PATIENTS Males with a history of spinal cord injury who attended an outpatient rehabilitation service. METHODS An analytical study examined adult male patients with complete spinal cord injury in rehabilitation. A modified Sexual Life Quality Questionnaire (SLQQ) examined quality of sexual life, with scores below 50 suggesting significant sexual dysfunction and dissatisfaction. The assessment evaluated age, occupation, marital status, comorbidities, and treatment methods. RESULTS A total of 80 patients were included; 33 (41%) had a thoracic spinal cord injury, and 47 (59%) had a lumbar spinal cord injury. Thirty-seven patients (46%) were dissatisfied with the quality of their sexual life; 29 patients (88%) with thoracic spinal cord injury and 8 patients (17%) with lumbar spinal cord injury were dissatisfied with the quality of their sexual life (p = 0.001). Patients with higher education level experienced less sexual dissatisfaction (p = 0.03). CONCLUSION Human sexuality involves numerous interconnected elements that impact on general health. Sexual pleasure, self-esteem, and personal relationships are crucial for patients with spinal cord injury to identify rehabilitation needs. These results indicate the importance of supporting sexual well-being in recovery. Further studies of sexual enjoyment and quality of life for patients with spinal cord injury are needed, using larger and more diverse populations.
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Affiliation(s)
- Paulina Lucia Acosta-Santillán
- Department of Physical Rehabilitation, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Maria Fernanda Toro-Sashida
- Department of Physical Rehabilitation, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Alejandra Viridiana Rosas-Mendoza
- Department of Physical Rehabilitation, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Clotilde Fuentes-Orozco
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Kelvin Jasso-García
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Paulina García de León-Flores
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Mel Paul Mellado-Téllez
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Silvia Alejandra Ibarra-Camargo
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Jonathan Matías Chejfec-Ciociano
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Francisco José Barbosa-Camacho
- Department of Psychiatry, Civil Hospital of Guadalajara Fray Antonio Alcalde, University Center of Health Sciences, University of Guadalajara, Guadalajara, Jalisco, México
| | - Juan Armando Flores-Prado
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Gabino Cervantes-Guevara
- Department of Wellbeing and Sustainable Development, Centro Universitario del Norte, University of Guadalajara, Guadalajara, Jalisco, México
| | - Enrique Cervantes-Pérez
- Department of Internal Medicine, Civil Hospital of Guadalajara Fray Antonio Alcalde, University Center of Health Sciences, University of Guadalajara, Guadalajara, Jalisco. México
| | - Guillermo Alonso Cevantes-Cardona
- Department of Philosophical, Methodological and Instrumental Disciplines, University Center of Health Sciences, University of Guadalajara, Guadalajara, Jalisco, México
| | | | - Alejandro González-Ojeda
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México.
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Gérard M, Charvier K, Leduc H, Courtois F. Looking Beyond the Chair: Psycho-Perceptual Predictors of Sexual Distress and Sexual Satisfaction in Individuals with Spinal Cord Injury. JOURNAL OF SEX RESEARCH 2023:1-18. [PMID: 37819254 DOI: 10.1080/00224499.2023.2260816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Despite a large body of biomedical research, little is known about the psychological and perceptual predictors of sexual satisfaction (SS) and sexual distress (SD) post spinal cord injury (SCI). Guided by a bio-psycho-perceptual framework, this cross-sectional research aimed at assessing SS and SD in a large SCI sample using validated patient-reported outcome measures (PROM). Significant correlates and predictors of SS and SD were also identified. Ninety-one men and women with SCI completed PROMs of SS and SD, as well as psychological (mood, sexual and body esteem) and perceptual (interoceptive awareness, trait mindfulness, sexual mindfulness) factors. Neurological profiles were also assessed, along with experience of orgasm. Correlates of SS and SD were first identified using Pearson's correlations, then multiple hierarchical regression models were computed to isolate predictors. Orgasm experience and psychological factors emerged as moderate correlates of both SS and SD, while neurological factors did not. Interoceptive awareness and trait mindfulness showed weak associations with SD and none with SS. Among the tested predictors, experience of orgasm emerged as the strongest for SS (β = -.29, p < .01), followed by mood, which predicted SS and SD. Sexual and body esteem was predictive of SD only. In sexually active participants, sexual mindfulness predicted both SS (β = 0.55, p < .001) and SD (β = -0.56, p < .001) above and beyond all other variables. This study reveals unique aspects of SS and SD postinjury and supports further consideration of psychological and perceptual dimensions of SCI sexuality in rehabilitation research.
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Affiliation(s)
- Marina Gérard
- Psychology Department, Université du Québec à Montréal
| | | | - Hugues Leduc
- Psychology Department, Université du Québec à Montréal
| | - Frédérique Courtois
- Sexology Department, Université du Québec à Montréal
- CIUSSS du Centre-Sud-de-l'Île-de-Montréal (CCSMTL), Gingras Lindsay Montreal Rehabilitation Institute (IRGLM)
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Lopes BS, Verraest X, Correia AR, Ermida V, Caldas J, Margalho P, Laíns J. Sexuality After Spinal Cord Injury. Which Factors Influence Sexual Activity and Satisfaction? SEXUALITY AND DISABILITY 2022. [DOI: 10.1007/s11195-022-09730-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Previnaire JG, Soler JM, Plets M, Denys P, Giuliano F. Urethral pressure profile during ejaculation in men with spinal cord injury. Int J Impot Res 2022:10.1038/s41443-022-00527-x. [PMID: 35027722 DOI: 10.1038/s41443-022-00527-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 12/12/2021] [Accepted: 01/04/2022] [Indexed: 11/09/2022]
Abstract
Ejaculation is often impaired in men with spinal cord injury (SCI). The aim of this prospective study was to assess sequence of sphincteric events and ejaculation dyssynergia during penile vibratory stimulation (PVS) in SCI men. Simultaneous recordings of bladder, bladder neck, prostate and external urethral sphincter pressures were performed using a microtip catheter with 5 pressure transducers. Between 2017 and 2019, ten men participated in the study for a total of 17 procedures. Antegrade ejaculation was found in three men with upper motor neuron (UMN) lesion. Ejaculation was preceded by a progressive increase in all urethral pressures, reaching sustained (plateau) or intermittent peaks above 220 cm H20. Antegrade ejaculation occurred after intermittent decreases in pressure at the external urethral sphincter level down to 100 cm H20, while the pressure at the bladder neck remained high (up to or above 220 cm H20). PVS was ineffective in eliciting ejaculation in seven men. In the five patients with UMN lesions, PVS elicited an increase in the external urethral sphincter pressure (mean 51 cm H20), while there was no pressure change in the two patients with lower motor neuron lesions. Due to lack of enough retrograde retrieval attempts, the hypothesis of ejaculatory dyssynergia could not be verified.
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Affiliation(s)
| | | | - Melody Plets
- Delegations for Clinical Research and Innovation, Lille Catholic Hospitals, Lille Catholic University, Lille, France
| | - Pierre Denys
- Neuro-Uro-Andrology, R. Poincare Academic Hospital, AP-HP, 104 bvd R. Poincare, 92380, Garches, France.,Faculty of Medicine, Versailles Saint Quentin University, UMR Inserm 1179, Paris Saclay, 78180, Montigny le Bretonneux, France
| | - François Giuliano
- Neuro-Uro-Andrology, R. Poincare Academic Hospital, AP-HP, 104 bvd R. Poincare, 92380, Garches, France.,Faculty of Medicine, Versailles Saint Quentin University, UMR Inserm 1179, Paris Saclay, 78180, Montigny le Bretonneux, France
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Aslan E, Acar Z, Yılmaz B. Reproductive and Sexual Health in Males with Physical, Hearing, and Vision Disabilities. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2021; 33:210-221. [PMID: 38596751 PMCID: PMC10929575 DOI: 10.1080/19317611.2021.1884164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 01/21/2021] [Accepted: 01/27/2021] [Indexed: 04/11/2024]
Abstract
Objective This study aimed to determine reproductive health, sexual functions, and sexual satisfaction levels of males with disabilities. Methods: The study had a cross-sectional, descriptive, and correlational design and was conducted on 136 males with disabilities. Data was collected using an introduction form, International Index of Erectile Function, the Erectile Performance Anxiety Index (EPAI), the Premature Ejaculation Profile (PEP), and the Sexual Satisfaction Scale (SSS). Results: The total EPAI score was 19.86 ± 8.98(10-50), the total PEP score was 9.91 ± 4.20(0-16) and the total SSS score was 86.79 ± 18.20(44-119). Conclusions: Education and counseling on reproductive and sexual health should be given based on their individual needs.
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Affiliation(s)
- Ergül Aslan
- Department of Women Health and Gynecologic Nursing, Istanbul University-Cerrahpasa, Florence Nightingale Faculty of Nursing, Istanbul, Turkey
| | - Zehra Acar
- Department of Women Health and Gynecologic Nursing, Istanbul University-Cerrahpasa, Florence Nightingale Faculty of Nursing, Istanbul, Turkey
| | - Büşra Yılmaz
- Department of Women Health and Gynecologic Nursing, Istanbul University-Cerrahpasa, Florence Nightingale Faculty of Nursing, Istanbul, Turkey
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Elliott S, Jeyathevan G, Hocaloski S, O’Connell C, Gulasingam S, Mills S, Farahani F, Kaiser A, Mohammad Alavinia S, Omidvar M, Craven BC. Conception and development of Sexual Health indicators to advance the quality of spinal cord injury rehabilitation: SCI-High Project. J Spinal Cord Med 2019; 42:68-84. [PMID: 31573441 PMCID: PMC6781482 DOI: 10.1080/10790268.2019.1612642] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Context: Although spinal cord injury or disease (SCI/D) results in complex biological and psychosocial impairments that adversely impact an individual's overall quality of sexual life, sexual health is poorly integrated into the current rehabilitation processes. Therefore, it is vital to promote sexual health as a rehabilitation priority. Herein, we describe the selection of Sexual Health structure, process and outcome indicators for adults with SCI/D in the first 18 months after rehabilitation admission. Methods: Experts in sexual health and the SCI-High team identified key factors that influence the sexual health outcomes of rehabilitation interventions to inform Driver diagram development. This diagram informed the selection and development of indicators to promote a permissive environment for discussion of sexual health issues among regulated health care professionals (HCPs). A review of literature and psychometric properties of measurement tools facilitated final indicators selection. Results: The structure indicator is the proportion of rehabilitation HCPs who have completed annual preliminary sexual health training. The process indicator is the proportion of SCI/D inpatients that have a documented introduction to available local sexual health resources. The outcome indicator is a sexual health patient questionnaire used to assess sexual health patient outcomes and sexual health information/educational needs. Rapid-cycle piloting verified that the indicator tools developed are feasible for implementation. Conclusion: Successful implementation of the Sexual Health structure, process and outcome indicators will promote a permissive environment to enable open discussion, and lead to provision of equitable and optimal care related to sexual health following SCI/D. This will ultimately advance sexual health rehabilitation across the nation.
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Affiliation(s)
- Stacy Elliott
- Sexual Health Rehabilitation Service, GF Strong Rehabilitation Center & Blusson Spinal Cord Centre, Vancouver, British Columbia, Canada,Faculty of Medicine, ICORD, University of British Columbia, Vancouver, British Columbia, Canada,BC Center for Sexual Medicine, Vancouver Hospital, Vancouver, British Columbia, Canada
| | - Gaya Jeyathevan
- KITE, Toronto Rehab – University Health Network, Toronto, Ontario, Canada
| | - Shea Hocaloski
- Sexual Health Rehabilitation Service, GF Strong Rehabilitation Center & Blusson Spinal Cord Centre, Vancouver, British Columbia, Canada
| | - Colleen O’Connell
- Stan Cassidy Centre for Rehabilitation, Fredericton, New Brunswick, Canada
| | - Sivakumar Gulasingam
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada,Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - Sandra Mills
- Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - Farnoosh Farahani
- KITE, Toronto Rehab – University Health Network, Toronto, Ontario, Canada
| | - Anita Kaiser
- KITE, Toronto Rehab – University Health Network, Toronto, Ontario, Canada,Canadian Spinal Research Organization, Toronto, Ontario, Canada
| | - S. Mohammad Alavinia
- KITE, Toronto Rehab – University Health Network, Toronto, Ontario, Canada,Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada
| | - Maryam Omidvar
- KITE, Toronto Rehab – University Health Network, Toronto, Ontario, Canada
| | - B. Catharine Craven
- KITE, Toronto Rehab – University Health Network, Toronto, Ontario, Canada,Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada,Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada,Correspondence to: B. Catharine Craven, Neural Engineering & Therapeutic Team, KITE, Toronto Rehabilitation Institute – University Health Network, 520 Sutherland Drive, Toronto, ON M4G 3V9, Canada; Ph: (416) 597-3422 (ext: 6122).
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Abstract
STUDY DESIGN Observational study (Ethics Committee Number 973.648). OBJECTIVE Evaluating the social and clinical factors associated with sexual dysfunction in men with traumatic spinal cord injury, as well as predictive factors for sexual dysfunction. SUMMARY OF BACKGROUND DATA Besides the motor and sensory loss, sexual function changes after spinal cord injury, ranging from decreased sexual desire to erectile disorders, orgasm, and ejaculation. METHODS Performed with 45 men, with traumatic spinal cord injury and sexually active. Sexual function was assessed by the International Index of Erectile Function and the level and degree of injury were determined following guidelines of International Standards for Neurological and Functional Examination Classification of Spinal Cord Injury. Bi and multivariate analysis was applied, with a 0.05 significance level. RESULTS Forty-five subjects with mean injury time of 7.5 years (CI 5.2-9.9) were evaluated. Having a fixed partner is a protective factor (OR: 0.25; 95% CI: 0.07-0.92) of erectile dysfunction. Sexual desire is associated with the fixed partner (OR: 0.12; 95% CI: 0.02-0.66), masturbation (OR: 0.13; 95% CI: 0.02-0.62), and sexual intercourse in the last month (OR: 0.13; 95% IC: 0.01-0.92). Ejaculation (OR: 0.01; 95% CI: 0.00-0.15) and erectile dysfunction (OR: 15.7; 95% CI: 1.38-178.58) are associated with orgasm. Psychogenic erection (OR: 0.07; 95% CI: 0.01-0.69), monthly frequency of sexual intercourse (OR: 11.3; 95% CI: 2.0-62.8), and orgasmic dysfunction (OR: 7.1; 95% CI: 1.1-44.8) are associated with satisfaction. CONCLUSION Fixed partner, ejaculation, masturbation are protective factors for sexual dysfunction. Erectile dysfunction, orgasmic, and infrequent sex dysfunction are predictors of sexual dysfunction. LEVEL OF EVIDENCE 3.
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