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19–22 APRIL, 2017, BARCELONA, SPAIN
S24-10 (P without presentation)
SEXUAL ACTIVITY AND FUNCTION IN ADULT MEN
WITH SPINA BIFIDA
Konrad SZYMANSKI
1
, Devon HENSEL
2
, John WIENER
3
, Benjamin WHITTAM
1
,
Martin KAEFER
1
, Katherine CHAN
1
, Richard RINK
1
, Mark CAIN
1
and Rosalia MISSERI
1
1) Riley Hospital for Children, Pediatric Urology, Indianapolis, USA - 2) Indiana University Purdue University Indianapolis,
Department of Pediatrics and Department of Sociology, Indianapolis, USA - 3) Duke University Medical Center, Pediatric
Urology, Durham, USA
PURPOSE
Little is known about sexual function of men with spina bifida (SB). The aim of this study was to
assess sexual activity and erectile dysfunction (ED) in men with SB.
MATERIAL AND METHODS
We performed an international online survey of men ≥18yo with SB. Participants were recruited via
SB clinics and social media. We collected data on demographics, ambulation (Hoffer classification),
penile rigidity (Erection Hardness Score), sexual activity and ED (International Index of Erectile
Function). Non-parametric tests were used for analysis.
RESULTS
Of 69 men (median age 35, 62.3% shunted, 27.1% community ambulators), 50.7% were single and
43.4% in a relationship (18.8% married). Overall, 35.3% reported full penile rigidity with erections,
more commonly in men with better ambulation (p=0.04). 66.2% of men achieved orgasm and 78.3%
ejaculated.
Lifetime solo masturbation was reported by 91.3%, partnered non-genital contact: 85.5%, mutual
masturbation: 78.3%, and partnered intercourse: 75.4% (62.3% vaginal). Median age at first sexual
contact was 19yr, with median 3.5 lifetime partners. Of 25 men who used phosphodiasterase type
5 (PDE5) inhibitors, 76.0% had improved erections, 56.0% improved intercourse.
Overall, 46.3% of men reported non-genital erogenous zones as most pleasurable, more commonly
in men with poorer ambulation (p=0.03). Nipples (38.7%) and chest (22.6%) were most common.
In 18 men (26.9%) who attempted sexual intercourse in the last 4 weeks, 61.1% had ED (16.7%
severe, 5.6% moderate, 22.2% mild-moderate, 16.7% mild). In this group, ED was present in
7/7 men with less than full penile rigidity, compared to 4/11 (36.4%) with full penile rigidity (p=0.01).
CONCLUSIONS
While ED is common in men with SB, PDE5 inhibitors are frequently used and may benefit this
population. Better ambulation is associated with better erectile function. Partnered sexual activity is
common, although may not involve penetrative intercourse.