Department of Urology, University of Michigan, Ann Arbor, MI.
Department of Urology, University of Michigan, Ann Arbor, MI.
Sex Med Rev. 2021 Apr;9(2):244-266. doi: 10.1016/j.sxmr.2020.09.001. Epub 2021 Feb 17.
As most adults with spina bifida are either sexually active or interested in becoming sexually active, providers should understand how spina bifida impacts sexual function and options for treatment.
The objective of this study is to summarize the current literature describing how features of spina bifida impact sexual function in men and women, effective available treatment options for sexual dysfunction, and to identify research gaps.
Searches were conducted in PubMed, CINAHL Complete, PsychInfo, Cochrane Central, Scopus, and Web of Science Core Collection databases using keywords related to spina bifida and sexual function. 34 primary research studies were included.
Most men (56-96%) can achieve an erection, although it may be insufficient for penetration. Although 50-88% ejaculate, it is often dripping, retrograde, or insensate. Twenty percent to 67% achieve orgasm. Generally, men with lower lesions and intact sacral reflexes have better outcomes, although some men with all levels of lesion report good function. Sildenafil is efficacious at treating erectile dysfunction for most men. The "TO-MAXimize sensation, sexuality, and quality of life" procedure may improve sexual function in selected men with low-level lesions. Female sexual function and treatment is less well understood. Women may experience decreased arousal, difficulties with orgasm, and pain. No treatment has been studied in women. Bowel and bladder incontinence during intercourse appears to be bothersome to men and women. Although both men and women have diminished sexual satisfaction, their sexual desire appears to be least impacted. Present studies are limited by studies' small, heterogeneous populations, the misuse of validated questionnaires in the sexually inactive population, and the lack of a validated questionnaire specific to people with spina bifida.
Spina bifida impacts the sexual function of both men and women. Future studies should seek a better understanding of female sexual function and treatment, use validated questionnaires appropriately, and ultimately create a validated sexual function questionnaire specific to this population. Streur CS, Corona L, Smith JE, et al. Sexual Function of Men and Women With Spina Bifida: A Scoping Literature Review. Sex Med Rev 2021;9:244-266.
由于大多数患有脊髓脊膜膨出的成年人都有性生活或有兴趣进行性生活，因此医务人员应了解脊髓脊膜膨出如何影响性功能以及治疗选择。
本研究旨在总结目前描述脊髓脊膜膨出如何影响男性和女性性功能的文献，以及性功能障碍的有效治疗选择，并确定研究空白。
使用与脊髓脊膜膨出和性功能相关的关键词，在 PubMed、CINAHL Complete、PsychInfo、Cochrane Central、Scopus 和 Web of Science Core Collection 数据库中进行检索。共纳入 34 项原始研究。
大多数男性（56%-96%）可以勃起，尽管可能不足以进行插入。虽然 50%-88%可以射精，但通常是滴状、逆行或无感觉的。20%-67%可以达到性高潮。一般来说，低位病变和骶反射完整的男性结局更好，但也有一些所有水平病变的男性报告功能良好。西地那非对大多数男性的勃起功能障碍有效。“TO-MAXimize 感觉、性和生活质量”手术可能改善低位病变男性的性功能。女性性功能和治疗的了解较少。女性可能会出现性欲减退、难以达到性高潮和疼痛。没有针对女性的治疗方法。性交时的肠道和膀胱失禁似乎令男性和女性都感到困扰。尽管男性和女性的性满意度都降低，但他们的性欲似乎受影响最小。目前的研究受到研究人群小、异质性、在非活跃人群中错误使用有效问卷以及缺乏针对脊髓脊膜膨出患者的有效问卷的限制。
脊髓脊膜膨出会影响男性和女性的性功能。未来的研究应深入了解女性性功能和治疗方法，正确使用有效问卷，并最终为该人群创建特定的性功能问卷。
