Sexual health and fertility issues

  • The spinal cord level of a patient’s defect may be predictive of several elements of sexual function, including independent erectile function and genital sensation.
  • Most patients with low spinal cord lesions (below L3) are capable of achieving spontaneous erections, whereas fewer than one in four patients with higher lesions have independent erectile function.
  • SB patients with erectile dysfunction (ED) frequently have a good response to oral phosphodiesterase-5 inhibitors.
  • There are also lower rates of intact penile sensation reported among patients with spinal cord lesions above the mid-lumbar spine.
  • Although at least some patients have difficulty with orgasm or ejaculation, the relationship between climactic function and the level of spinal cord lesions is not yet entirely clear.
  • Male fertility also may be related to the patient’s spinal cord lesion level, and it is also important to discuss with patients that they may have an increased risk of having a child with SB.
  • Sexuality among females with SB is also understudied at the current time.
  • Females with lower spinal lesions are more frequently able to achieve orgasm, paralleling the sexual dysfunction seen in the male population.
  • It is thought that the incidence of pregnancy-related complications may be higher for mothers with SB and their children.
  • Mothers with SB have a higher risk of intensive care unit admission and respiratory morbidity than the general population, and their infants have a higher risk of hemorrhage, birth hypoxia, and prolonged length of hospital stay.
Transitional urology
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