Characterizing sexual involvement in patients with spinal cord injury admitted to the Julio Díaz Rehabilitation Center in Havana, Cuba. 2015
DOI:
https://doi.org/10.28957/rcmfr.v29n1a6Keywords:
sexuality, Spinal Cord Injury.Abstract
Introduction: spinal cord injury is a pathological process that produces changes in motor, sensory and autonomic functions, which affects the sexuality of most people who suffer from it. However, although there are innumerable services for the rehabilitation of these patients, sexual aspects are not systematically incorporated.
Objective: To characterize the sexual involvement of male patients with spinal cord injury. Material and method: a descriptive cross-sectional observational study was performed at the Medullary Injury Service of the Julio Díaz National Rehabilitation Center in Havana, Cuba. The universe was composed by 119 patients and the sample was made up by 20 of them. Their individual medical records were reviewed, an interview and physical examination were performed, the Rotter Incomplete Sentences Blank test was applied and the subject were asked to complete the projective paragraph with the sentence «My sexuality and me”.
Results: traumatic spinal cord injury was more frequent in cases under 40 and in the thoracic region; a significant percentage of patients lost their stable partner and, consequently, were more likely to not adapt psychologically. Their spinal cord injury did not affect their sexual desire rather the organic sexual response, which negatively influenced the self-assessment of their sexuality. Negative social factors are not perceived as circumstances that affect sexuality, although they suggest that overcrowding, architectural barriers and difficulties with transportation negatively influence their quality of life. Most cases reported that they needed to have their sexual problems treated.
Conclusions: medullary Injury is a condition that severely alters sexuality in its biological, psychological and social sphere, regardless of age and level of injury; however, most patients do not receive appropriate attention to their difficulties, a fact that constitutes a deficiency in the rehabilitation process.
References
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3. García-Carenas L, Alcedo-Rodríguez MA, Aguado-Díaz AL. La sexualidad de las perso- nas con lesión medular: aspectos psicológi- cos y sociales. Una revisión actualizada. Intervención Psicosocial. 2008;17(2):125-41.
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8. American Spinal Injury Association (ASIA). International Standards for Neurological Classif ication of Spinal Cord Injur y. Chicago: ASIA; 2002.
9. Martínez-Angulo MR. Manual de técnicas de exploración psicológica. La Habana: Edi- torial Pueblo y Educación; 2013.
10. Bors E, Comarr AE. Neurological disturban- ces of sexual function with special reference to 529 patients with spinal cord injury. Urol Surv. 1960;110:191-221.
11. DeForge D J y colaboradores. Male erectile dysfunction following spinal cord injury: a systematic review. Spinal Cord 2006; 44:465-73.
12. Franceschini M, Di Clemente B, Rampello A, Nora M, Spizzichino L. Longitudinal outcome 6 years after spinal cord injury. Spinal Cord. 2003;41(5):280-5. Disponible en: http://dx.doi.org/10.1038/sj.sc.3101457.
13. Sipski ML, Jackson AB, Gómez-Marín O, Estores I, Stein A. Effects of gender on neurologic and functional recover y after spinal cord injury. Arch Phys Med Rehabil. 2004;85(11):1826-36. Disponible en: https://doi.org/10.1016/j.apmr.2004.04.031.
14. Bloemen-Vrencken JH, De Witte LP, Post MW, van den Heuvel WJ. Health behaviour of persons with spinal cord injury. Spinal Cord. 2007;45(3):243-9. Disponible en: https://doi.org/10.1038/sj.sc.3101967.
15. Liang HW, Wang YH, Lin YN, Wang JD, Jang Y. Impact of age on the injury pattern and survival of people with cer vical cord injuries. Spinal Cord. 2001;39(7):375-80. Dis- ponible en: https://doi.org/10.1038/ sj.sc.310116910.1038/sj.sc.3101967
16. Henao Lema CP, Pérez Parra JE. Lesiones medulares y discapacidad: revisión bibliográ- fica. Aquichan. 2010;10(2):157-72
17. Robles-Ortiz J, González-Roig JL, Saborit- Oliva Y, Machado-Moreno L, Jacas-Prado D. Epidemiología de la lesión medular traumática. Rev Cub de Med Fis y Rehab. 2012 [citado 2019 jul 18];4(2):85-94. Dispo- nible en: http://bvs.sld.cu/revistas/mfr/ vol_4_2_12/mfr02212.pdf.
18. Rodríguez-Castiñeira R, Jiménez-Morales RM, Cordero-Montes R, Brunet-Gómez D, Macías-Delgado Y. Conducta sexual en hombres con lesión medular traumática. Gac Méd. 2014 [citado 2015 sep 22]16(1):12-9
Disponible en: http://scielo.sld.cu/pdf/gme/v16n1/gme03114.pdf.
19. Franco-Chacón N, Aguilar-Chavarría E, García-Rojas V, Gómez Montoya L, Jiménez- Quesada G, Quiñones-Corrales E, et al. Abordaje de la sexualidad en el proceso de rehabilitación de personas con lesión medular. Rev. Enfermería Actual en Costa Rica. 2009 [citado 2015 sep 22];16. Dispo- nible en: https://dialnet.unirioja.es/servlet/ articulo?codigo=5021221.
20. Elliott TR, Frank RG. Depression following spinal cord injury. Arch Phys Med Rehabil. 1996;77(8):816-23. Disponible en: https://doi.org/10.1016/S0003-9993(96)90263-4.
21. Kalpakjian CZ, Albright KJ. An examination of depression through the lens of spinal cord injur y. Comparative prevalence rates and severity in women and men. Womens Health Issues 2006;16(6): 380-8. Disponible en: https://doi.org/10.1016/j.whi.2006.08.005.
22. González-Noriega MM. Depresión y otras variables psicológicas en el proceso de adap- tación a la lesión medular [tesis]. Salamanca: Universidad de Salamanca; 2014 [citado 2019 jul 18]. Disponible en: http://gredos.usal.es/ xmlui/handle/10366/125488
23. Dimitriadis F, K arakitsios, Tsounapi P, Tsambalas S, Loutradis D, Kanakas N, et al. Erectile function and male reproduction in men with spinal cord injur y: a review. Andrologia. 2010;42(3):139-65. Disponible en: https://doi.org/10.1111/j.1439-0272.2009.00969.x.
24. Rahimi-Movaghar V, Vaccaro AR. Mana- gement of sexual disorders in spinal cord injured patients. Acta Med Iran. 2012 [cita- do 2015 sep 22];50(5):295-9. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/
22837080.
25. Tsuji I, Nakajima F, Morimoto J, Nounaka Y. The sexual function in patients with spinal cord injury. Urol Int. 1961;12:270-80. Disponible en: Disponible en: https:// doi.org/10.1159/000277578.
26. Alexander M, Rosen RC. Spinal cord inju- ries and orgasm: a review. J Sex Marital Ther. 2008;34(4):308-24. Disponible en: https://doi.org/10.1080/0092623080209634110.1159/000277578.
27. Alexander CJ, Sipski ML, Findley T W. Sexual activities, desire, and satisfaction in males pre- and post-spinal cord injury. Arch
Sex Behav. 1993;22(3):217-28. Disponible en:https://doi.org/10.1007/bf01541767.
28. Dahlberg A, Alaranta HT, Kautiainen H, Kotila M. Sexual activity and satisfaction in men with traumatic spinal cord lesion. J Rehabil Med. 2007;39(2):152-5. Disponible en: https://doi.org/10.2340/16501977-0029.
29. Talbolt HS. The sexual function in paraplegia. J Urol. 1995;73(1):91-100. Dispo- nible en: https://doi.org/10.1016/s0022-
5347(17)67370-1.
30. Hess MJ, Hough S. Impact of spinal cord injur y on sexuality: Broad-based clinical practice inter vention and practical appli- cation. J Spinal Cord Med. 2012; 35(4):211-8. Disponible en: https://doi.org/10.1179/
2045772312Y.0000000025.
31. Fitzpatrick WF. Sexual function in theparaplegic patient. Arch Phys Med Rehabil. 1974;55(5):221-27.
32. Munro D, Horne HW, Paul DP. The effect of injury to the spinal cord and cauda equina on the sexual potency of men. N Engl J Med. 1948;239(24):903-11. Disponible en: https://doi.org/10.1056/NEJM194812092392401.
33. Sandowsky C. Sexuality and the paraplegic. Rehabilitation Literature. 1976;37(10-11): 322-7.
34. Zeitlin AB, Cottrell TL, Lloyd F. Sexology of the paraplegic male. Fertil steril.1957; 8 (4):337-344. Disponible en: https://doi.org/10.1016S0015-0282(16)32763-7.
35. Sunilkumar MM, Boston P, Rajagopal MR. Sexual Functioning in Men Living with a Spinal Cord Injury-A Narrative Literature Review. Indian J Palliat Care. 2015;21(3):274-81. Disponible en: https://doi.org/10.4103/
0973-1075.164886.
36. Singh U, Gogia VS, Handa G. Occult problem in paraplegia- A case report. Indian J Phys Med Rehabil. 2002;13:19-23.
37. Ostrander N. Sexual pursuits of pleasure among men and women with spinal cord injuries. Sex Disabil. 2009;27(1):11-9. Disponible en: https://doi.org/10.1007/s11195-008-9103-y.
38. Sharma SC, Singh R, Dogra R, Gupta SS. Assessment of sexual functions after spinal cord injury in Indian patients. Int J Rehabil Res. 2006;29(1):17-25. Disponible en: https: //doi.org/10.109701.mrr.00001855947.56810.fc.
39. Barbonetti A, Cavallo F, Felzani G, Francavilla S, Francavilla F. Erectile dysfunction is the main determinant of psychological distress in men with spinal cord injury. J Sex Med 2012;9:830-6.
40. Westgren N, Levi R. Quality of life and traumatic spinal cord injury. Arch Phys Med Rehabil 1998; 79:1433-9.
41. Castillo Cuello JJ. Los senderos del placer. Editorial CENESEX. La Habana, 2011.
42. Cobo Cuenca A I y colbs. Calidad de vida del varón con lesión medular traumática y disfunción sexual. Enfermería Clínica 2012;22(4):205-8.
2. Castillo-Cuello JJ. Acercamiento y proble- ma sexual con las personas con discapacidad en salud, malestares y problemas sexuales. La Habana: CENESEX; 2013.
3. García-Carenas L, Alcedo-Rodríguez MA, Aguado-Díaz AL. La sexualidad de las perso- nas con lesión medular: aspectos psicológi- cos y sociales. Una revisión actualizada. Intervención Psicosocial. 2008;17(2):125-41.
4. Castillo-Cuello JJ: Discapacidad y sexualidad. Un acercamiento al diagnóstico y su atención. La Habana: CENESEX; 2006.
5. Castillo-Cuadros J, Tapia-Zambrano C. Sexualidad en el lesionado medular: caracterización de la población masculina en control en el Hospital del Trabajador de Santiago, Chile. Rev Col Med Fis Rehab. 2012;22(1):32-43.
6. Castillo-Cuello JJ. Enfoques para una aten- ción integral de la sexualidad de las perso- nas con discapacidad. Revista Sexología y Sociedad. 2010; 43 (16): 4-12. Versión digital Disponible en: http://revsexologiaysociedad.sld.cu/index.php/sexologiaysociedad/ article/view/396/438
7. Castillo J J, Figueredo L, Infante I, Cano A M. Discapacitados en la comunidad. Progra- mas de educación sexual. Sexología y sociedad. 1997; año 2 (9): 35-37. Versión digital Disponible en: http://revsexologiaysociedad. sld.cu/index.php/sexologiaysociedad/ article/view/143/184
8. American Spinal Injury Association (ASIA). International Standards for Neurological Classif ication of Spinal Cord Injur y. Chicago: ASIA; 2002.
9. Martínez-Angulo MR. Manual de técnicas de exploración psicológica. La Habana: Edi- torial Pueblo y Educación; 2013.
10. Bors E, Comarr AE. Neurological disturban- ces of sexual function with special reference to 529 patients with spinal cord injury. Urol Surv. 1960;110:191-221.
11. DeForge D J y colaboradores. Male erectile dysfunction following spinal cord injury: a systematic review. Spinal Cord 2006; 44:465-73.
12. Franceschini M, Di Clemente B, Rampello A, Nora M, Spizzichino L. Longitudinal outcome 6 years after spinal cord injury. Spinal Cord. 2003;41(5):280-5. Disponible en: http://dx.doi.org/10.1038/sj.sc.3101457.
13. Sipski ML, Jackson AB, Gómez-Marín O, Estores I, Stein A. Effects of gender on neurologic and functional recover y after spinal cord injury. Arch Phys Med Rehabil. 2004;85(11):1826-36. Disponible en: https://doi.org/10.1016/j.apmr.2004.04.031.
14. Bloemen-Vrencken JH, De Witte LP, Post MW, van den Heuvel WJ. Health behaviour of persons with spinal cord injury. Spinal Cord. 2007;45(3):243-9. Disponible en: https://doi.org/10.1038/sj.sc.3101967.
15. Liang HW, Wang YH, Lin YN, Wang JD, Jang Y. Impact of age on the injury pattern and survival of people with cer vical cord injuries. Spinal Cord. 2001;39(7):375-80. Dis- ponible en: https://doi.org/10.1038/ sj.sc.310116910.1038/sj.sc.3101967
16. Henao Lema CP, Pérez Parra JE. Lesiones medulares y discapacidad: revisión bibliográ- fica. Aquichan. 2010;10(2):157-72
17. Robles-Ortiz J, González-Roig JL, Saborit- Oliva Y, Machado-Moreno L, Jacas-Prado D. Epidemiología de la lesión medular traumática. Rev Cub de Med Fis y Rehab. 2012 [citado 2019 jul 18];4(2):85-94. Dispo- nible en: http://bvs.sld.cu/revistas/mfr/ vol_4_2_12/mfr02212.pdf.
18. Rodríguez-Castiñeira R, Jiménez-Morales RM, Cordero-Montes R, Brunet-Gómez D, Macías-Delgado Y. Conducta sexual en hombres con lesión medular traumática. Gac Méd. 2014 [citado 2015 sep 22]16(1):12-9
Disponible en: http://scielo.sld.cu/pdf/gme/v16n1/gme03114.pdf.
19. Franco-Chacón N, Aguilar-Chavarría E, García-Rojas V, Gómez Montoya L, Jiménez- Quesada G, Quiñones-Corrales E, et al. Abordaje de la sexualidad en el proceso de rehabilitación de personas con lesión medular. Rev. Enfermería Actual en Costa Rica. 2009 [citado 2015 sep 22];16. Dispo- nible en: https://dialnet.unirioja.es/servlet/ articulo?codigo=5021221.
20. Elliott TR, Frank RG. Depression following spinal cord injury. Arch Phys Med Rehabil. 1996;77(8):816-23. Disponible en: https://doi.org/10.1016/S0003-9993(96)90263-4.
21. Kalpakjian CZ, Albright KJ. An examination of depression through the lens of spinal cord injur y. Comparative prevalence rates and severity in women and men. Womens Health Issues 2006;16(6): 380-8. Disponible en: https://doi.org/10.1016/j.whi.2006.08.005.
22. González-Noriega MM. Depresión y otras variables psicológicas en el proceso de adap- tación a la lesión medular [tesis]. Salamanca: Universidad de Salamanca; 2014 [citado 2019 jul 18]. Disponible en: http://gredos.usal.es/ xmlui/handle/10366/125488
23. Dimitriadis F, K arakitsios, Tsounapi P, Tsambalas S, Loutradis D, Kanakas N, et al. Erectile function and male reproduction in men with spinal cord injur y: a review. Andrologia. 2010;42(3):139-65. Disponible en: https://doi.org/10.1111/j.1439-0272.2009.00969.x.
24. Rahimi-Movaghar V, Vaccaro AR. Mana- gement of sexual disorders in spinal cord injured patients. Acta Med Iran. 2012 [cita- do 2015 sep 22];50(5):295-9. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/
22837080.
25. Tsuji I, Nakajima F, Morimoto J, Nounaka Y. The sexual function in patients with spinal cord injury. Urol Int. 1961;12:270-80. Disponible en: Disponible en: https:// doi.org/10.1159/000277578.
26. Alexander M, Rosen RC. Spinal cord inju- ries and orgasm: a review. J Sex Marital Ther. 2008;34(4):308-24. Disponible en: https://doi.org/10.1080/0092623080209634110.1159/000277578.
27. Alexander CJ, Sipski ML, Findley T W. Sexual activities, desire, and satisfaction in males pre- and post-spinal cord injury. Arch
Sex Behav. 1993;22(3):217-28. Disponible en:https://doi.org/10.1007/bf01541767.
28. Dahlberg A, Alaranta HT, Kautiainen H, Kotila M. Sexual activity and satisfaction in men with traumatic spinal cord lesion. J Rehabil Med. 2007;39(2):152-5. Disponible en: https://doi.org/10.2340/16501977-0029.
29. Talbolt HS. The sexual function in paraplegia. J Urol. 1995;73(1):91-100. Dispo- nible en: https://doi.org/10.1016/s0022-
5347(17)67370-1.
30. Hess MJ, Hough S. Impact of spinal cord injur y on sexuality: Broad-based clinical practice inter vention and practical appli- cation. J Spinal Cord Med. 2012; 35(4):211-8. Disponible en: https://doi.org/10.1179/
2045772312Y.0000000025.
31. Fitzpatrick WF. Sexual function in theparaplegic patient. Arch Phys Med Rehabil. 1974;55(5):221-27.
32. Munro D, Horne HW, Paul DP. The effect of injury to the spinal cord and cauda equina on the sexual potency of men. N Engl J Med. 1948;239(24):903-11. Disponible en: https://doi.org/10.1056/NEJM194812092392401.
33. Sandowsky C. Sexuality and the paraplegic. Rehabilitation Literature. 1976;37(10-11): 322-7.
34. Zeitlin AB, Cottrell TL, Lloyd F. Sexology of the paraplegic male. Fertil steril.1957; 8 (4):337-344. Disponible en: https://doi.org/10.1016S0015-0282(16)32763-7.
35. Sunilkumar MM, Boston P, Rajagopal MR. Sexual Functioning in Men Living with a Spinal Cord Injury-A Narrative Literature Review. Indian J Palliat Care. 2015;21(3):274-81. Disponible en: https://doi.org/10.4103/
0973-1075.164886.
36. Singh U, Gogia VS, Handa G. Occult problem in paraplegia- A case report. Indian J Phys Med Rehabil. 2002;13:19-23.
37. Ostrander N. Sexual pursuits of pleasure among men and women with spinal cord injuries. Sex Disabil. 2009;27(1):11-9. Disponible en: https://doi.org/10.1007/s11195-008-9103-y.
38. Sharma SC, Singh R, Dogra R, Gupta SS. Assessment of sexual functions after spinal cord injury in Indian patients. Int J Rehabil Res. 2006;29(1):17-25. Disponible en: https: //doi.org/10.109701.mrr.00001855947.56810.fc.
39. Barbonetti A, Cavallo F, Felzani G, Francavilla S, Francavilla F. Erectile dysfunction is the main determinant of psychological distress in men with spinal cord injury. J Sex Med 2012;9:830-6.
40. Westgren N, Levi R. Quality of life and traumatic spinal cord injury. Arch Phys Med Rehabil 1998; 79:1433-9.
41. Castillo Cuello JJ. Los senderos del placer. Editorial CENESEX. La Habana, 2011.
42. Cobo Cuenca A I y colbs. Calidad de vida del varón con lesión medular traumática y disfunción sexual. Enfermería Clínica 2012;22(4):205-8.
How to Cite
1.
Guerrero Ferreira NA, Castillo Cuello JJ. Characterizing sexual involvement in patients with spinal cord injury admitted to the Julio Díaz Rehabilitation Center in Havana, Cuba. 2015. Rev. Colomb. Med. Fis. Rehabil. [Internet]. 2019 Sep. 4 [cited 2024 May 15];29(1):40-51. Available from: https://revistacmfr.org/index.php/rcmfr/article/view/227
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2019-09-04
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