Quality of life of males with spinal cord injury and sexual dysfunction, "Beyond the Abstract," by Ana Isabel Cobo Cuenca, PhD

BERKELEY, CA (UroToday.com) - The causes of spinal cord injuries can be congenital, traumatic or medical. The most frequent one is traumatic. In general, people who suffer spinal cord injuries (SCI) have a lower quality of life (QOL) than people without SCI. Lesser QOL is reported by patients who have urinary infections, urinary and/or intestinal dysfunction, motor dysfunction, pain, pressure ulcers, and sexual dysfunction.

The aims of this study were to assess the quality of life of males with spinal cord injury (SCI) and to know their sexual health. We also analyzed the links among clinic and socio-demographic variables, the sexual health of males with SCI, and their QOL.

This was a transversal cross-sectional study that was made in the National Hospital of Paraplegics of Toledo. The sample was representative and it included 45 men with spinal cord injury (SCI) and sexual dysfunction (SD). The size of the sample was calculated accepting an α error=0,05, β= 0.80 and a difference of averages in the scale LISSAT-8 (σ= 5.6; SD=6.3) for independent samples. The sample size was 23, assuming 10% of losses. The data collection took place in the Urology service of the National hospital of Paraplegics of Toledo during eleven months (January 2009-November 2010), and all patients who met the study inclusion criteria were included. These were: a) males between 18 and 55 years of age, b) Chronic spinal cord injury which began over than one year ago, and c) Level injury from C6 to caudal equine.

Measures:

  • The Fugl-Meyer Life Satisfaction Questionnaire (LISAT-8) - is self-administered and comprises 8 items. A total General Life Satisfaction score can be calculated, or the items can be grouped into three dimensions: Satisfaction with Social Life, Sexual Life, and Economic Life.[1]
  • Sexual Health Measurement Scale - collects data about the clinical backgrounds which can cause the sexual dysfunction; the frequency and satisfaction with sexual relations, and the type of sexual dysfunctions which have been diagnosed (the disorder can affect: sexual desire, erection, orgasm, ejaculation, etc.)[2]

All procedures were approved by the human ethics research committee of the Hospital. The participants were SCI patients who were attending their annual urological check-up at the National Hospital of Paraplegics (NHP) of Toledo. Those patients who met the inclusion criteria were invited to participate in the study, and they were informed about their voluntary participation. Also, their anonymity and the protection of their data were guaranteed. 

Data were collected through a face-to-face structured interview during the urological check-up. Each interview lasted about 10 minutes, and it was performed by one researcher who worked at the hospital. The participants were first asked about socio-demographic data and later they answered the self-administered scales.

The demographics characteristics, and those related to their health, are shown in Table 1. It was learned that 97.8% of all participants were interested in having sexual relationships; 70% of all participants had a steady sexual partner while 51% often maintained sexual relations. 86% of the sample admitted to suffering from erectile dysfunction and 71% reported they couldn’t ejaculate. The score of the group with erectile dysfunction was significantly low in sexual QOL (p 0.0001) and in general QOL (p 0.001).

The sample had an average, in general QOL, of 34.27 (standard deviation: 2.8), in social QOL, 20.16 (SD:2.7), in sexual QOL, 7.62 (SD:2.7), and in economic QOL 7.71 (SD:2.6). There wasn’t a significant relationship between QOL and the etiology, degree, and time of evolution of the SCI.

The group that had sexual partners scored significantly higher in general QOL (p 0.0001) than the group that didn’t have sexual partners. There weren’t any relationships among the other variables related to sexual health and the QOL.

In others studies, people who suffer SCI can learn to adequately adapt and achieve a good quality of life.[3,4] Participants in this study reported a “good” general quality of life and a “very good” social life, but their sexual life is the aspect that causes them a greater dissatisfaction (it is considered only acceptable). These results are similar to others reported by Kennedy, et al.[3] research conducted with 350 spinal cord injury patients of the United Kingdom, Germany, Switzerland, and Austria. The same conclusions appear in other studies made in Italy and United States.[4,5,6,7]

bta Cobo-Cuenca fig1 thumb

References:

  1. Moncada I, Micheltorena CF, Martínez-Sánchez EM, Rejas J. Evaluation of the psychometrics properties of the LISAT-8 checklist as a screening tool erectile dysfunction. J Sex Med. 2008;5:83-91.
  2. Tomás R, Tárraga López PJ, Álvarez MC, Cerdán Oliver M, Celada Rodríguez A, Solera Albero. Disfunciones sexuales en Atención Primaria. MGF. 2007; 92:13-23.
  3. Kennedy P, Lude P, Taylor N. Quality of life, social participation, appraisals and coping post spinal cord injury: A review of four community samples. Spinal Cord. 2006; 44:99---105
  4. Haran MJ, Lee B, King MT, Marial O, Stockler M. Health status rated with the Medical Outcomes Study 36-Item Short-Form Health Survey after spinal cord injury. Arch Phys Med Rehab. 2008;86:90.
  5. Salinas J, Martín C, Vírseda M. Tipos de disfunción eréctil neurógena: Lesión medular traumática. En: Salinas J, Martín C, Vírseda M, editores. Bases neurológicas de la erección, Disfunción eréctil neurógena. Madrid: Gráficas Santher; 2003. p. 165-78.
  6. Lombardi G, Macchiarella A, Cecconi F, Aito S, Del Popolo G. Sexual life of males over 50 years of age with spinal cord lesions of al least 20 years. Spinal Cord. 2008;46: 679-83.
  7. Lidal IB, Veenstra M, Hjeltnes N, Biering-Sorensen F. Healthrelated quality of life in persons with long-standing spinal cord injury. Spinal Cord. 2008;46:710-5.

Written by:
Ana Isabel Cobo Cuenca, PhD as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.

E.U.Enfermeria y Fisioterapia de Toledo, Campus Tecnológico "Fábrica de Armas," Av. Carlos III. Toledo, Spain

Quality of life of males with spinal cord injury and sexual dysfunction - Abstract

More Information about Beyond the Abstract