Sexuality after spinal cord Injury. Which factors influence sexual activity and satisfaction?

The impact of sexual impairment in spinal cord injured patients is complex and multifactorial. Despite its importance, the factors that determine their sexual activity and satisfaction are mostly unknown. The objectives of this study were to identify and characterize sexual activity among these patients, assess their sexual satisfaction and elucidate the factors that influence it. We designed a cross-sectional study, consisting in a telephone questionnaire, addressing some topics about sexuality and sexual satisfaction, applied to spinal cord injured individuals previously admitted to a Rehabilitation Hospital. A total of 112 individuals accepted to answer the survey. Sexual activity was reported by 49 (43.8%) and was associated with younger age, higher functional status, male gender and active employment status. Higher sexual satisfaction was significantly associated with younger age, younger age at the time of injury, active employment status and sexual counselling after lesion. No correlation was found between sexual activity or sexual satisfaction and neurologic level, AIS classification or the etiology of the lesion. We concluded that sexual performance after SCI is not exclusively determined by genital function and the degree of physical impairment. Personal and contextual factors (in particular, those which promote social participation) seems to be stronger determinants of sexual activity and sexual satisfaction than the neurologic characteristics of the lesion. This study reinforces the importance of a comprehensive rehabilitation program, including sexual counselling to SCI individuals and their partners.