SEXUAL FUNCTION DURING PRIMARY REHABILITATION AFTER SPINAL CORD INJURY IN SWITZERLAND – A DESCRIPTIVE ANALYSIS Free

To describe sexual function and factors associated with alterations in sexual function in females and males during post-acute spinal cord injury (SCI) rehabilitation.

Data on sexual function, based on the International Spinal Cord Society (ISCoS) female sexual and reproductive function and male sexual function basic data sets were collected during the inpatient rehabilitation stay after SCI by a prospective, population-based, multicenter, longitudinal study, the Swiss Spinal Cord Injury (SwiSCI) Inception Cohort, from 2013 to 2024.

Sexual function could be reported as “normal”, “altered/reduced”, “absent”, or “unknown”. Sex-stratified multivariable logistic regression modelling was used to evaluate the association between SCI severity (American Spinal Cord Injury Association Impairment Scale (AIS) grade), level, and etiology, age, and each sexual function outcome.

Data were available for 605 individuals with a median age of 54. A median 5.0 months after SCI (Q1-Q3: 3.4-5.8), 30% of females (42/140) and 54% of males (249/465) had a “known” status for all sexual (and reproductive) function domains (p < 0.001). Normal reflex genital arousal and orgasmic function were reported by 23% and 17% of the females, respectively. For 54% (27/50) of females under 45 years, experience or symptoms of menstruation were considered normal. Normal psychogenic and reflex erection were reported by 22% and 26% of the males, respectively. 16% had normal ejaculation and 16% had normal orgasmic function.

In both females and males, SCI severity was associated with abnormal function, in females AIS grades A and B (vs. AIS C and D) nearly perfectly predicted “absent” or “altered” function in both orgasm and reflex arousal (p < 0.024, both). In males, AIS A and B were highly predictive in all domains (all p < 0.0001). Older age was an additional factor associated with all domains of sexual dysfunction in males (all p < 0.06).

This study provides a first description of sexual function during primary rehabilitation after SCI, with low rates of normal function observed across various domains, particularly in females. SCI severity was associated with sexual function outcomes. These results could help to better integrate targeted sexual function assessments and management into SCI rehabilitation.

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