A STUDY OF SEXUAL FUNCTION IN SPINAL CORD INJURIES

Abstract

In 114 patients with spinal cord injuries, sexual function was investigated by use of questionnaire and erection ability was examined by genital skin temperature, by dividing the patients into four groups: accrding to the level of the spinal cord injury into upper and lower paralysis cases with 9th and 10th thoracic cord as the dividing level, and according to the degree of paralysis into complete and incomplete paralysis cases. The patients age ranged from 16 years to 58 (mean: 34.2 years). The mean duration of the illness was 3 years and 4 months. Results of the questionnaire revealed that reflex erection was present in 90.1% and intercourse was possible in 72.5% of cases for the upper complete paralysis group. In another hand, the lower complete paralysis group ejaculation was possible in 15.3%. psychic erection and orgasm feeling were present in less than 10% of cases for both groups. Curves of changes in genital skin temperature in response to sexual stimulation-visual sexual stimulation (V. S. S) and penile mechanical stimulation (P. M. S) showed five patterns: normo-response, reflex-response, hypo-response, mixed-response and non-response. The reflex-response pattern was observed in 88.2% for upper complete paralysis group. The mixed-response pattern accounted for 40% and the normo-response pattern 33.3% of cases for upper incomplete paralysis group. The non-response pattern in 38.4% and hypo-response pattern in 30.7% of cases for lower complete paralysis group. The normo-response pattern in 63.6% of cases for lower incomplete paralysis group.
In each group a strong positive correlation was seen between the genital skin temperature curve and the degree of erection. However, no erection was observed in 5 cases (22.7%) of lower incomplete paralysis group despite of elevation in skin temperature. These findings suggest that blood stresm is not only the factor that is responsible for the phenomenon of erection.