The effect of spinal cord level on sexual function in the spina bifida population

Summary Introduction Sexual dysfunction and infertility are prevalent in the spina bifida (SB) population; however, the mechanism of how they affect a person with spina bifida is poorly understood. Additionally, the management of children with spina bifida becomes more difficult as they exit from pe...

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Published in:Journal of pediatric urology 2015-06, Vol.11 (3), p.142.e1-142.e6
Main Authors: Lee, N.G, Andrews, E, Rosoklija, I, Logvinenko, T, Johnson, E.K, Oates, R.D, Estrada, C.R
Format: Article
Language:English
Subjects:
Adolescent
Adult
Case-Control Studies
Cohort Studies
Female
Humans
Infertility
Infertility - epidemiology
Male
Pediatrics
Sex Factors
Sexual Behavior
Sexual dysfunction
Sexual Dysfunction, Physiological - epidemiology
Spina bifida
Spinal Dysraphism - complications
Spinal Dysraphism - pathology
Spinal Dysraphism - psychology
Surveys and Questionnaires
Urology
Young Adult
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Summary:Summary Introduction Sexual dysfunction and infertility are prevalent in the spina bifida (SB) population; however, the mechanism of how they affect a person with spina bifida is poorly understood. Additionally, the management of children with spina bifida becomes more difficult as they exit from pediatric institutes. Objective The present study sought to evaluate sexual health (using validated questionnaires) and fertility in adults with spina bifida and to correlate spinal cord level and ambulatory status with degree of sexual function. Study design After institutional board review approval, 199 adult patients with SB, aged 18 and older and who were followed in one pediatric institution, were identified. Patients who were non-English speaking, cognitively and/or developmentally delayed, or unable to be contacted were excluded. Surveys regarding demographics, sexual health and infertility were mailed to the patients and administered in the clinic with the option to opt-out of the survey. Survey questions regarding sexual health were constructed using validated questionnaires: Female Sexual Function Index (FSFI) for females, and International Index of Erectile Function (IIEF) and Sexual Health Inventory for Men (SHIM) for males. Sexual dysfunction scores were correlated to the patients' spinal level and ambulatory status. Results Of the 121 eligible patients, 45 replied, with a response rate of 39%. For females, using a cut-off value of 26.5 for FSFI scoring, 25 out of 28 (89%) had sexual dysfunction. No association was seen between spinal level or ambulatory status and overall FSFI, satisfaction, or desire scores. For males, 10 out of 17 (59%) had severe erectile dysfunction (ED), and one out of 17 (6%) had no ED. No association was seen between ambulatory status and sexual function scores for the males. However, SHIM, satisfaction, and ED scores were higher in males with lower spinal lesions. People with spina bifida of both genders tended to have moresevere dysfunction compared to those with sexual dysfunction of other etiologies, except with similar sexual desire scores. Regarding questions on fertility, no participant attempted to have children; thus, there was no infertility reported. Discussion Few studies have been conducted on sexual health and fertility in adults with SB. Three studies have utilized validated questionnaires and found varying degrees of sexual dysfunction in this subset of patients; however, only one study found sexual activity to
ISSN:1477-5131
1873-4898
DOI:10.1016/j.jpurol.2015.02.010