P-51: Treatment of Sexual Dysfunction in Patients with Spinal Cord Injury

Background Regaining arm and hand function was deemed the most important by quadriplegics, while regaining sexual function was given the highest priority for paraplegics. Improving bladder and bowel function was of shared importance to both injury groups. The objective of this study was to conduct a systematic review and meta-analysis of the existing research on patients with spinal cord injury and therapy of sexual dysfunction. MaterialsAndMethods Science Direct, Pubmed, Cochrane, CINAHL, Embase, ProQuest Dissertations, scopus, (2000 through 2012) were searched for English-language studies using a list of keywords. The books about physical therapy and medical and neurological were studied too. Results Sexual arousal and libido are determined by psychological factors, general well-being, and hormones like testosterone . Early sexological counselling is supplied in our rehabilitation centre, not only for the needs of the patients but just as much for the partner of the patient, who is facing “a new sexuality, with most of the time a more active role”. Partners are confronted with patients with many frustrations, unrealistic expectations, depression, and aggression, which situation does not promote the resumption of their sexual activity. Hormone substitution is rarely needed early on except after testicular trauma or lesions of the hypophysis. Once rehabilitation advances, mild testosterone deficiencies might require therapy not only for increasing libido and arousal but also to ameliorate the sexual dysfunction, general well-being, muscle strength, and bone structure. Conclusion Therapy for erectile dysfunction and ejaculatory dysfunction related to fertility treatments is well established but not the treatment of dysfunction of sexual performance and/or orgasm. Special attention is given to priapism and its treatment in patients with spinal cord injury.