Sexual dysfunction in men with spinal cord injury: a case-control study.

The objective of this study is to confirm that spinal cord injury (SCI) alters the neurological pathways of sexual function (SF) and to ascertain whether other differences exist among men with SCI compared with men without SCI (WSCI) and sexual dysfunction (SD). The method comprise a case study of 98 men with SCI and SD, and 89 men with WSCI and SD as controls. A questionnaire was administered to these men regarding their SF, anxiety, depression, self-esteem and quality of life. Additionally, a penile eco-Doppler study was performed after a prostaglandin E1 (PGE1) injection, in addition to neurophysiological tests of the innervation pathways of SF. The mean age of cases (39.35 years) was significantly lower than the control group (48.5 years). The SCI group had a higher frequency of ejaculatory disorders, and the WSCI group had a higher frequency of decreased sexual desire, erectile dysfunction (ED) and premature ejaculation. The WSCI group had greater anxiety and depression than the SCI group. The systolic velocities of both cavernous arteries were higher in the SCI group. Significant differences were observed in electromyography of the bulbocavernosus muscle, pudendal sensory thresholds, somatosensory potentials, genital sympathetic potentials and electromyography of the cavernous bodies after PGE1 injection. SCI causes significant alterations in the innervation pathways of SF.