Neurogenic Sexual Dysfunction in Spinal Cord Injured – Retrospective Study

Detalhes bibliográficos
Autor(a) principal: Magalhães, Sílvia; Interna de MFR do Centro de Medicina de Reabilitação de Alcoitão, Portugal
Data de Publicação: 2014
Outros Autores: Batista, Glória; Médica Fisiatra do Centro de Medicina de Reabilitação de Alcoitão, Portugal, Martin, Maria; Médica Fisiatra do Centro de Medicina de Reabilitação de Alcoitão, Portugal, Pereira, Elisabete; Psicóloga do Centro de Medicina de Reabilitação de Alcoitão, Portugal
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.25759/spmfr.109
Resumo: Background: Spinal cord injury is an important cause of disability, with many physical and psycho-social repercussions. Sexuality in patients with Spinal Cord Injury (SCI) is frequently compromised, determining low levels of satisfaction with it. There are several therapeutic options available nowadays, that can be associated to other interventions, such as psychological and behavioural counseling, pharmacological therapy, penile vibratory stimulation, among others. Despite this fact, it remains as an area least addressed in the long-term SCI patient rehabilitation, with unquestionable repercussions in the individual/couple physical and mental well-being and social and family integration. Objective: Characterize demographic and clinically the population of SCI paraplegic patients followed in a Neurogenic Sexual Dysfunction Consultation, identifying the most common therapeutic interventions done. Methods and Subjects: Retrospective longitudinal study of paraplegic patients followed in a Neurogenic Sexual Dysfunction Consultation, between 2005 and 2008. Socio-demographical, clinical and therapeutic intervention data were collected from clinical files. Results: A total of 178 paraplegic patients were followed in a Neurogenic Sexual Dysfunction Consultation between 2005 April and 2008 December, aged between 18 e 81 years-old and of male gender in the majority. Traumatic etiology was the main cause of SCI, with similar number of complete and incomplete lesions. 48% of patients had neurological levels above D10 and 37% between D10 and L2. 87,7% of the male patients with complete lesions had some type of erection (reflexogenic, psychogenic or both); in incomplete lesions, erection was present in 94,6% . Only 28 % of the males had antegrade ejaculation. Of the non-ejaculating patients, 28 (18%) were submitted to treatment with penile vibratory stimulation, with positive result (antegrade ejaculation) in 43% of those cases. Phosphodiesterase type-5 inhibitors were the commonest therapeutic used in male patients and vaginal lubricant in women. Psychological intervention was provided to 37,6% of patients. Conclusions: SCI impact on sexuality is significant, determining a change on the way the individual and the couple live it. Clinical intervention of Sexual Reeducation allows the patient guidance to a sexuality rediscovery and to make it more satisfying, through the available therapeutic resources, contributing strongly to the psycho-social well-being of the disabled patient. Keywords: Sexual Dysfunction, Physiological; Paraplegia 
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spelling Neurogenic Sexual Dysfunction in Spinal Cord Injured – Retrospective StudyDisfunção Sexual Neurogénea em Paraplégicos – Estudo RetrospectivoBackground: Spinal cord injury is an important cause of disability, with many physical and psycho-social repercussions. Sexuality in patients with Spinal Cord Injury (SCI) is frequently compromised, determining low levels of satisfaction with it. There are several therapeutic options available nowadays, that can be associated to other interventions, such as psychological and behavioural counseling, pharmacological therapy, penile vibratory stimulation, among others. Despite this fact, it remains as an area least addressed in the long-term SCI patient rehabilitation, with unquestionable repercussions in the individual/couple physical and mental well-being and social and family integration. Objective: Characterize demographic and clinically the population of SCI paraplegic patients followed in a Neurogenic Sexual Dysfunction Consultation, identifying the most common therapeutic interventions done. Methods and Subjects: Retrospective longitudinal study of paraplegic patients followed in a Neurogenic Sexual Dysfunction Consultation, between 2005 and 2008. Socio-demographical, clinical and therapeutic intervention data were collected from clinical files. Results: A total of 178 paraplegic patients were followed in a Neurogenic Sexual Dysfunction Consultation between 2005 April and 2008 December, aged between 18 e 81 years-old and of male gender in the majority. Traumatic etiology was the main cause of SCI, with similar number of complete and incomplete lesions. 48% of patients had neurological levels above D10 and 37% between D10 and L2. 87,7% of the male patients with complete lesions had some type of erection (reflexogenic, psychogenic or both); in incomplete lesions, erection was present in 94,6% . Only 28 % of the males had antegrade ejaculation. Of the non-ejaculating patients, 28 (18%) were submitted to treatment with penile vibratory stimulation, with positive result (antegrade ejaculation) in 43% of those cases. Phosphodiesterase type-5 inhibitors were the commonest therapeutic used in male patients and vaginal lubricant in women. Psychological intervention was provided to 37,6% of patients. Conclusions: SCI impact on sexuality is significant, determining a change on the way the individual and the couple live it. Clinical intervention of Sexual Reeducation allows the patient guidance to a sexuality rediscovery and to make it more satisfying, through the available therapeutic resources, contributing strongly to the psycho-social well-being of the disabled patient. Keywords: Sexual Dysfunction, Physiological; Paraplegia Introdução: A Lesão Medular (LM) é uma importante causa de incapacidade, com múltiplas repercussões físicas e psico-sociais. A resposta sexual dos portadores de lesão medular está geralmente comprometida, proporcionando baixos níveis de satisfação. A intervenção terapêutica faz-se a vários níveis, recorrendo a aconselhamento psico- comportamental, terapêutica farmacológica, vibro-estimulação, entre outras. Mantém-se como uma das áreas menos abordadas na reabilitação do lesionado medular crónico, com inevitáveis repercussões no bem-estar físico e mental do indivíduo/casal e na sua reintegração sócio-familiar. Objectivo: Caracterizar demográfica e clinicamente a população de lesionados medulares paraplégicos seguidos em Consulta de Disfunção Sexual Neurogénea (DSN), identificando o tipo de intervenção terapêutica realizada. População e Métodos: Estudo longitudinal retrospectivo dos paraplégicos acompanhados na Consulta de DSN, entre 2005 e 2008. Resultados: Foram acompanhados 178 indivíduos paraplégicos na Consulta de DSN entre Abril de 2005 e Dezembro de 2008, com idades entre os 18 e os 81 anos, sendo a grande maioria do género masculino. A etiologia traumática foi a causa mais frequente de LM, havendo um número similar de lesões completas e incompletas. Dos utentes do género masculino portadores de LM completa, 87,7% apresentava algum tipo de erecção (reflexa, psicogénea ou ambas); nas LM incompletas aquela estava presente em 94,6%. Apenas 28% dos utentes apresentava ejaculação anterógrada. Da população restante (sem ejaculação), 28 (18%) foram sujeitos a tratamento com vibro-estimulador, sendo o resultado positivo (ejaculação anterógrada) em 43% dos casos. Os inibidores da fosfodiesterase tipo 5 foram a terapêutica mais utilizada para a disfunção eréctil e foi prescrito lubrificante vaginal à maioria das mulheres. Foi realizado acompanhamento psicológico em 37,6% dos casos. Conclusões: O impacto da lesão medular na sexualidade é significativo e altera a vivência da mesma em termos individuais e de casal. A intervenção clínica no âmbito da Reeducação Sexual permite orientar as pessoas para a redescoberta da sexualidade e actuar, através das terapêuticas disponíveis, no sentido de a tornar mais gratificante, contribuindo de forma indelével para a melhoria do bem-estar bio-psico-social dos indivíduos portadores de deficiência. Palavras-chave: Disfunção Sexual Neurogénea; Paraplegia. Sociedade Portuguesa de Medicina Física e de Reabilitação2014-01-27T00:00:00Zjournal articlejournal articleinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://doi.org/10.25759/spmfr.109oai:ojs.spmfrjournal.org:article/109Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação; v. 24, n. 2 (2013): Ano 21; 31-350872-9204reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://spmfrjournal.org/index.php/spmfr/article/view/109https://doi.org/10.25759/spmfr.109https://spmfrjournal.org/index.php/spmfr/article/view/109/85Magalhães, Sílvia; Interna de MFR do Centro de Medicina de Reabilitação de Alcoitão, PortugalBatista, Glória; Médica Fisiatra do Centro de Medicina de Reabilitação de Alcoitão, PortugalMartin, Maria; Médica Fisiatra do Centro de Medicina de Reabilitação de Alcoitão, PortugalPereira, Elisabete; Psicóloga do Centro de Medicina de Reabilitação de Alcoitão, Portugalinfo:eu-repo/semantics/openAccess2022-09-20T15:28:41Zoai:ojs.spmfrjournal.org:article/109Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:51:16.802678Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Neurogenic Sexual Dysfunction in Spinal Cord Injured – Retrospective Study
Disfunção Sexual Neurogénea em Paraplégicos – Estudo Retrospectivo
title Neurogenic Sexual Dysfunction in Spinal Cord Injured – Retrospective Study
spellingShingle Neurogenic Sexual Dysfunction in Spinal Cord Injured – Retrospective Study
Magalhães, Sílvia; Interna de MFR do Centro de Medicina de Reabilitação de Alcoitão, Portugal
title_short Neurogenic Sexual Dysfunction in Spinal Cord Injured – Retrospective Study
title_full Neurogenic Sexual Dysfunction in Spinal Cord Injured – Retrospective Study
title_fullStr Neurogenic Sexual Dysfunction in Spinal Cord Injured – Retrospective Study
title_full_unstemmed Neurogenic Sexual Dysfunction in Spinal Cord Injured – Retrospective Study
title_sort Neurogenic Sexual Dysfunction in Spinal Cord Injured – Retrospective Study
author Magalhães, Sílvia; Interna de MFR do Centro de Medicina de Reabilitação de Alcoitão, Portugal
author_facet Magalhães, Sílvia; Interna de MFR do Centro de Medicina de Reabilitação de Alcoitão, Portugal
Batista, Glória; Médica Fisiatra do Centro de Medicina de Reabilitação de Alcoitão, Portugal
Martin, Maria; Médica Fisiatra do Centro de Medicina de Reabilitação de Alcoitão, Portugal
Pereira, Elisabete; Psicóloga do Centro de Medicina de Reabilitação de Alcoitão, Portugal
author_role author
author2 Batista, Glória; Médica Fisiatra do Centro de Medicina de Reabilitação de Alcoitão, Portugal
Martin, Maria; Médica Fisiatra do Centro de Medicina de Reabilitação de Alcoitão, Portugal
Pereira, Elisabete; Psicóloga do Centro de Medicina de Reabilitação de Alcoitão, Portugal
author2_role author
author
author
dc.contributor.author.fl_str_mv Magalhães, Sílvia; Interna de MFR do Centro de Medicina de Reabilitação de Alcoitão, Portugal
Batista, Glória; Médica Fisiatra do Centro de Medicina de Reabilitação de Alcoitão, Portugal
Martin, Maria; Médica Fisiatra do Centro de Medicina de Reabilitação de Alcoitão, Portugal
Pereira, Elisabete; Psicóloga do Centro de Medicina de Reabilitação de Alcoitão, Portugal
description Background: Spinal cord injury is an important cause of disability, with many physical and psycho-social repercussions. Sexuality in patients with Spinal Cord Injury (SCI) is frequently compromised, determining low levels of satisfaction with it. There are several therapeutic options available nowadays, that can be associated to other interventions, such as psychological and behavioural counseling, pharmacological therapy, penile vibratory stimulation, among others. Despite this fact, it remains as an area least addressed in the long-term SCI patient rehabilitation, with unquestionable repercussions in the individual/couple physical and mental well-being and social and family integration. Objective: Characterize demographic and clinically the population of SCI paraplegic patients followed in a Neurogenic Sexual Dysfunction Consultation, identifying the most common therapeutic interventions done. Methods and Subjects: Retrospective longitudinal study of paraplegic patients followed in a Neurogenic Sexual Dysfunction Consultation, between 2005 and 2008. Socio-demographical, clinical and therapeutic intervention data were collected from clinical files. Results: A total of 178 paraplegic patients were followed in a Neurogenic Sexual Dysfunction Consultation between 2005 April and 2008 December, aged between 18 e 81 years-old and of male gender in the majority. Traumatic etiology was the main cause of SCI, with similar number of complete and incomplete lesions. 48% of patients had neurological levels above D10 and 37% between D10 and L2. 87,7% of the male patients with complete lesions had some type of erection (reflexogenic, psychogenic or both); in incomplete lesions, erection was present in 94,6% . Only 28 % of the males had antegrade ejaculation. Of the non-ejaculating patients, 28 (18%) were submitted to treatment with penile vibratory stimulation, with positive result (antegrade ejaculation) in 43% of those cases. Phosphodiesterase type-5 inhibitors were the commonest therapeutic used in male patients and vaginal lubricant in women. Psychological intervention was provided to 37,6% of patients. Conclusions: SCI impact on sexuality is significant, determining a change on the way the individual and the couple live it. Clinical intervention of Sexual Reeducation allows the patient guidance to a sexuality rediscovery and to make it more satisfying, through the available therapeutic resources, contributing strongly to the psycho-social well-being of the disabled patient. Keywords: Sexual Dysfunction, Physiological; Paraplegia 
publishDate 2014
dc.date.none.fl_str_mv 2014-01-27T00:00:00Z
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https://spmfrjournal.org/index.php/spmfr/article/view/109/85
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publisher.none.fl_str_mv Sociedade Portuguesa de Medicina Física e de Reabilitação
dc.source.none.fl_str_mv Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação; v. 24, n. 2 (2013): Ano 21; 31-35
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