Myelomeningocele and sexuality

Abstract

Purpose This study was designed to evaluate sexual (dys)function in adult myelomeningocele patients. Furthermore to evaluate the influence of the sex, and of the neurological level. Material and methods 169 adult patients with spina bifida were included . A validated questionnaire on sexual function and the medical records were studied. So far 74 patients have returned the questionnaire (32 men and 42 women).We also divided patients into groups according to their neurological level. Results About half the group had a partner and 83.3 % had a desire for sexual contact. 75% had had sexual contact of some form and 60 % had had intercourse. 30 to 45 % of patients experienced problems with arousal, orgasm and sensitivity of the genital area when having sexual contact. 50 % of the men experienced erectile dysfunction. 6 % of the female patients had problems with lubrication. Besides this, many patients mention incontinence (20 of 54) and difficulties with positions and pain (23 of 54) during sexual contact. In this study women had more sexual contacts than men. Genital sensitivity problems were more frequently encountered in the male group and men also stated more often that their condition had a major impact on their sexual lives. The group with neurological level S1 or lower, more often had a partner and sexual contact compared with their peers with higher neurological levels. For other sexual functions the level of the lesion did not seem to cause relevant differences. Conclusions Myelomeningocele patients are in general sexually active, but sexual dysfunction is frequently encountered . Overall the level of neurological deficit is of less importance than expected. From this study it is evident that the pediatric urologist has to actively enquire about sexual function and provide a special forum for these patients to address these issues.