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Sexual activity and function of adult men with spina bifida.

Publication ,  Journal Article
Szymanski, KM; Roth, JD; Hensel, DJ; Wiener, JS; Younsi, N; Stein, R; Whittam, B; Kaefer, M; Rink, RC; Cain, MP; Misseri, R
Published in: J Pediatr Urol
June 2023

OBJECTIVE: Data on sexual function of men with spina bifida (SB) is limited. We aimed to assess sexual activity and erectile dysfunction (ED) in a large international sample of men with SB. METHODS: Men with SB (≥18yo) were recruited in an international online survey via clinics and social media. We collected data on demographics, ambulation (Hoffer classification), penile rigidity (Erection Hardness Score), sexual activity and ED (International Index of Erectile Function). Non-parametric tests were used. RESULTS: A total of 162 men (median age 35, 62% shunted, 38% community ambulators) reported sexual desire similar to the general population (p = 0.82), but 55% were dissatisfied with their sex life (Summary Table). Overall, 36% reported full penile rigidity with erections, more commonly with better ambulation (p = 0.01), 69% had ever experienced orgasm and 84% ejaculated. In 44 men (27%) attempting sexual intercourse in the last 4 weeks, 59% had ED (11% severe, 7% moderate, 14% mild-moderate, 27% mild). In this group, 91% of men reporting less than full penile rigidity had ED, compared to 30% with full penile rigidity (p = 0.001). Overall, partnered non-genital contact in the last 3 months was reported by 56%, solo masturbation: 62%, partnered intercourse: 48% (31% vaginal). Of 54 men who used phosphodiesterase type 5 inhibitors (PDE5I), 80% reported improved erections, 56% improved intercourse. Overall, 40% reported non-genital erogenous zones as most pleasurable, especially with poorer ambulation (p = 0.002, chest/nipples: 73%). COMMENT: Strengths of this study include anonymous, voluntary, online participation maximizing participation of a heterogenous, international population. Whenever available, we compared findings to published values for the general population. Since romantic and sexual activity is a complex intersection of interest, opportunity and ability, a more comprehensive assessment was beyond the study's scope. Future work will focus on the interplay with issues like incontinence. CONCLUSIONS: ED was frequent among men with SB, especially in men with poorer ambulation. PDE5 inhibitors may be beneficial. Partnered sexual activity was reported by half of the men, although it may not involve penetrative intercourse.

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Published In

J Pediatr Urol

DOI

EISSN

1873-4898

Publication Date

June 2023

Volume

19

Issue

3

Start / End Page

308.e1 / 308.e9

Location

England

Related Subject Headings

  • Urology & Nephrology
  • Spinal Dysraphism
  • Sexual Behavior
  • Penile Erection
  • Orgasm
  • Male
  • Humans
  • Female
  • Erectile Dysfunction
  • Adult
 

Citation

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Szymanski, K. M., Roth, J. D., Hensel, D. J., Wiener, J. S., Younsi, N., Stein, R., … Misseri, R. (2023). Sexual activity and function of adult men with spina bifida. J Pediatr Urol, 19(3), 308.e1-308.e9. https://doi.org/10.1016/j.jpurol.2023.03.002
Szymanski, Konrad M., Joshua D. Roth, Devon J. Hensel, John S. Wiener, Nina Younsi, Raimund Stein, Benjamin Whittam, et al. “Sexual activity and function of adult men with spina bifida.J Pediatr Urol 19, no. 3 (June 2023): 308.e1-308.e9. https://doi.org/10.1016/j.jpurol.2023.03.002.
Szymanski KM, Roth JD, Hensel DJ, Wiener JS, Younsi N, Stein R, et al. Sexual activity and function of adult men with spina bifida. J Pediatr Urol. 2023 Jun;19(3):308.e1-308.e9.
Szymanski, Konrad M., et al. “Sexual activity and function of adult men with spina bifida.J Pediatr Urol, vol. 19, no. 3, June 2023, pp. 308.e1-308.e9. Pubmed, doi:10.1016/j.jpurol.2023.03.002.
Szymanski KM, Roth JD, Hensel DJ, Wiener JS, Younsi N, Stein R, Whittam B, Kaefer M, Rink RC, Cain MP, Misseri R. Sexual activity and function of adult men with spina bifida. J Pediatr Urol. 2023 Jun;19(3):308.e1-308.e9.
Journal cover image

Published In

J Pediatr Urol

DOI

EISSN

1873-4898

Publication Date

June 2023

Volume

19

Issue

3

Start / End Page

308.e1 / 308.e9

Location

England

Related Subject Headings

  • Urology & Nephrology
  • Spinal Dysraphism
  • Sexual Behavior
  • Penile Erection
  • Orgasm
  • Male
  • Humans
  • Female
  • Erectile Dysfunction
  • Adult