Erectile dysfunction is the main determinant of psychological distress in men with spinal cord injury - Abstract

Introduction:The weight of erectile dysfunction (ED) among the various determinants of psychological distress in men with spinal cord injury (SCI) remains to be clarified.

Aim: The aim of this article was to evaluate psychological distress features in SCI men with or without ED.

Methods: Forty consecutive patients with neurologically stable SCI were included in the study. Functional independence (FI) was assessed by Barthel Index (BI), which was divided into global score (questions 1-10) and bowel/bladder subscore (questions 5 and 6). Erectile function was evaluated with Sexual Health Inventory for Men (SHIM).

Main Outcome Measures: Psychological distress was assessed with the Symptom Checklist-90-revised (SCL-90-R), scoring nine primary dimensions and their combination as Global Severity Index, a global index of psychological distress.

Results: All SCL-90-R scores and the percentage of patients with scores >75th percentile of the entire study population were significantly higher in the group with ED (Nā€ƒ=ā€ƒ21) than without ED (Nā€ƒ=ā€ƒ19). Most of SCL-90-R subscales were inversely correlated with SHIM score. ED was exhibited by a high proportion (84%) of men with thoracolumbar lesions but by no patients with cervical lesions. Men with cervical lesions exhibited significantly lower SCL-90-R scores than those with thoracolumbar lesions, in spite of lower FI. However, the thoracolumbar group also reported a more severe bowel/bladder dysfunction. At multivariate logistic regression analysis, ED score significantly explained the variance of most of SCL-90-R dimension scores, whereas no association was revealed between global BI and any score of SCL-90-R dimensions. Bowel/bladder BI explained only to a very low extent the variance of depressive symptoms.

Conclusions: Healthcare providers should be aware of the importance of managing ED in spinal cord-injured men, as it represents a major determinant of their psychological distress, independently of the degree of FI impairment.

Written by:
Barbonetti A, Cavallo F, Felzani G, Francavilla S, Francavilla F. Are you the author?
Andrologic Unit, Department of Internal Medicine, University of L'Aquila, L'Aquila, Italy; Centre for Clinical Research, San Raffaele Sulmona, Sulmona, Italy.

Reference: J Sex Med. 2012 Mar;9(3):830-6.
doi: 10.1111/j.1743-6109.2011.02599.x

PubMed Abstract
PMID: 22188659