Effect of Level of Spinal Cord Injury and Urinary Catheterization on Sexual Function and Activity in Male Patients with Upper Motor Neuron Injury

Woo Heon Cha; Ki Ho Kim; Young Jin Seo; Kyung Seop Lee

doi:10.4111/kju.2009.50.12.1225

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Cha, Kim, Seo, and Lee: Effect of Level of Spinal Cord Injury and Urinary Catheterization on Sexual Function and Activity in Male Patients with Upper Motor Neuron Injury

Original Article

Sexual Dysfunction/Infertility

Korean Journal of Urology

Korean Journal of Urology 2009; 50(12): 1225-1230.

Published online: 18 December 2009

DOI: https://doi.org/10.4111/kju.2009.50.12.1225

Effect of Level of Spinal Cord Injury and Urinary Catheterization on Sexual Function and Activity in Male Patients with Upper Motor Neuron Injury

Woo Heon Cha, Ki Ho Kim, Young Jin Seo, Kyung Seop Lee

Department of Urology, College of Medicine, Dongguk University, Gyeongju, Korea.

Correspondence to: Kyung Seop Lee. Department of Urology, College of Medicine, Dongguk University, 1090-1, Seokjang-dong, Gyeongju 780-350, Korea. TEL: 054-770-8265, FAX: 054-771-0769, ksleemd@dongguk.ac.kr

Received 27 November 2009 Accepted 3 December 2009

Abstract

Purpose

We investigated the effect of the level of spinal cord injury and urinary catheterization on sexual function and activity in male patients with upper motor neuron (UMN) injury.

Materials and Methods

We reviewed patient's chart, radiologic and urodynamic study. We interviewed patient's sexual activity according to educational status, economic and marriage state, occupation, duration of spinal cord injury and pattern of voiding. A total of 114 male patients with neurogenic bladder due to UMN injury were included in the study. Group 1 consisted of 33 patients who underwent a clean intermittent catheterization (CIC) regimen and group 2 consisted of 81 patients with a suprapubic catheter, condom catheter, or Foley catheter. A detailed sexual behavior was taken for all patients to complete a questionnaire including the 5-item version of the International Index of Erectile Function (IIEF-5).

Results

Satisfaction with intercourse (p=0.037) and total score (p=0.032) on the IIEF-5 were significantly higher in group 1 than in group 2. The other items on the IIEF-5 did not differ significantly between the groups. When the subjects were stratified according to level of spinal cord injury, 8 patients (18.6%) with cervical cord injury had no sexual activity, whereas 24 patients (33.8%) with non-cervical-cord injury did (p=0.048). Patients with no sexual activity were 12.1% (4/33) of the patients in the CIC group and 34.6% (28/81) of the patients who underwent other regimens (p=0.016).

Conclusions

Our results demonstrate that level of spinal cord injury and urinary catheterization may influence the sexual activity of male patients with UMN injury. Our results suggest that the CIC regimen had a positive effect on the sexual activity of these patients.

Keywords: Spinal cord injuries, Urinary catheterization, Erectile dysfunction

Figures and Tables

Table 1

Baseline patient characteristics

Group 1: thirty-three patients with clean intermittent catheterization regimens, Group 2: eighty-one patients with suprapubic catheter, condom catheter and Foley catheter, BMI: body mass index, ^a: statistical analysis was done by Student's t-test, ^b: statistical analysis was done by chi-square test

Table 2

Domain scores on the IIEF-5^a in both groups

Group 1: thirty-three patients with clean intermittent catheterization regimens, Group 2: eighty-one patients with suprapubic catheter, condom catheter and Foley catheter, IIEF: International Index of Erectile Function, ^a: statistical analysis was done by Student's t-test

Table 3

Comparison of patient characteristics according to sexual activity^a

CIC: clean intermittent catherization, ^a: sexual activity defined as IIEF-5 score 5-25 and no sexual activity as IIEF-5 score 1-4, ^b: statistical analysis was done by chi-square test

Table 4

Multivariate analysis for variables for no sexual activity^a

OR: odds ratio, CI: confidence interval, CIC: clean intermittent catherization, ^a: no sexual activity defined as IIEF-5 score 1-4, ^b: statistical significance was done by logistic regression analysis

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