Skip to main content

Advertisement

Log in

The Impact of Urinary Incontinence on Sexual Function and Sexual Satisfaction in Women with Spinal Cord Injury

  • Original Paper
  • Published:
Sexuality and Disability Aims and scope Submit manuscript

Abstract

Sexual function is a major concern for many individuals following spinal cord injury (SCI). Sexuality after SCI is a complex issue that is influenced by a number of social, psychological and physiological factors, including urinary incontinence (UI). To examine the experience of sexuality for women with SCI, to determine the impact of UI on sexual function and sexual satisfaction in these women, and to identify their main concerns regarding UI and sexuality. Using a phenomenological approach, seven in-depth interviews combining the interview guide approach and standardized open-ended questions were conducted. Two main categories were identified: Sexuality and the impact of UI on sexuality. Related themes were uncovered within each category. Both categories revealed emerging themes including 13 for sexuality and 10 for the impact of UI on sexuality. Five additional themes relevant to the research question but that did not fit into the initial categories were also identified. Intimacy and the sexual experience were negatively affected by UI as a result of SCI, and by an excessive concern about autonomic dysreflexia. There is a significant shortage of information available for women with SCI regarding sexual function in general, but more specifically, a lack of information on sexual function as it relates to UI. Future research should focus on creating resources to assist in this area which may improve the quality of life for these individuals.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Sipski, L.M., Alexander, C.J., Rosen, R.: Orgasm in women with spinal cord injuries: a laboratory-based assessment. Arch. Phys. Med. Rehabil. 76, 1097–1102 (1995)

    Article  PubMed  Google Scholar 

  2. Sipski, M.L., Alexander, C.J., Rosen, R.C.: Physiological parameters associated with sexual arousal in women with incomplete spinal injury. Arch. Phys. Med. Rehabil. 78, 305–313 (1997)

    Article  PubMed  Google Scholar 

  3. Sipski, L.M., Alexander, C.J., Rosen, R.: Sexual arousal and orgasm in women: effects of spinal cord injury. Ann Neurol. 49, 35–44 (2001)

    Article  PubMed  Google Scholar 

  4. Komisaruk, B.R., Whipple, B., Crawford, A., Liu, W.C., Kalnin, A., Mosier, K.: Brain activation during vaginocervical self-stimulation and orgasm in women with complete spinal cord injury: FMRI evidence of mediation by the vagus nerves. Brain Res. 1024, 77–88 (2004)

    PubMed  Google Scholar 

  5. Whipple, B., Komisaruk, B.R.: Brain (PETG) responses to vaginal-cervical self-stimulation in women with complete spinal cord injury: preliminary findings. J. Sex Marital Ther. 28, 79–86 (2002)

    Article  PubMed  Google Scholar 

  6. Kreuter, M., Siösteen, A., Biering-Sørensen, F.: Sexuality and sexual life in women with spinal cord injury: a controlled study. J. Rehabil. Med. 40, 61–69 (2008)

    Article  PubMed  Google Scholar 

  7. Pentland, W., Walker, J., Minnes, P., Tremblay, M., Brouwer, B., Gould, M.: Women with spinal cord injury and the impact of aging. Spinal Cord. 40, 374–387 (2002)

    Article  PubMed  Google Scholar 

  8. Singh, R., Sharma, S.C.: Sexuality and women with spinal cord injury. Sex. Disabil. 23, 21–33 (2005)

    Article  Google Scholar 

  9. Reitz, A., Stöhrer, M., Kramer, G., Del Popolo, G., Chartier-Kastler, E., Pannek, J., Burgdörfer, H., Göcking, K., Madersbacher, H., Schumacher, S., Richter, R., Von Tobel, J., Schurch, B.: European experience of 200 cases treated with botulinum-A toxin injections into detrusor muscle for urinary incontinence due to neurogenic detrusor overactivity. Eur. Urol. 45, 510–515 (2004)

    Article  PubMed  Google Scholar 

  10. Do Ngoc Thanh, C., Audry, G., Forin, V.: Botulinum toxin type A for neurogenic detrusor overactivity due to spinal cord lesions in children: a retrospective study of seven cases. J Pediatr Urol 5, 430–436 (2009)

    Article  PubMed  Google Scholar 

  11. Horton, J.A., Chancellor, M.B., Labatia, I.: Bladder management for the evolving spinal cord injury: options and considerations. Top. Spin. Cord Inj. Rehabil. 9, 36–52 (2003)

    Article  Google Scholar 

  12. Shuttleworth, K.E.D.: Urinary tract diseases: incontinence. Br. Med. J. 4, 727–729 (1970)

    Article  PubMed Central  PubMed  Google Scholar 

  13. Schurch, B., Hauri, D., Rodic, B., Curt, A., Meyer, M., Rossier, A.: Botulinum-A toxin as a treatment of detrusor-sphincter dyssynergia: a prospective study in 24 spinal cord injury patients. J. Urol. 155, 1023–1029 (1996)

    Article  PubMed  Google Scholar 

  14. Ferreiro-Velasco, M.E., Barca-Buyo, A., Salvador de la Barrear, S., Montoto-Marqués, A., Miguéns Vázquez, X., Rodriguez-Sotillo, A.: Sexual issues in a sample of women with spinal cord injury. Spinal Cord. 43, 51–55 (2005)

    Article  PubMed  Google Scholar 

  15. Valtonen, K., Karlsson, A., Siösteen, A., Dahlöf, L., Vikari-Juntura, E.: Satisfaction with sexual life among persons with traumatic spinal cord injury and meeningomyelocele. Disabil. Rehabil. 28, 965–976 (2006)

    Article  PubMed  Google Scholar 

  16. Patton, M.Q.: Qualitative research & evaluation methods, pp. 350–351. Sage, Thousand Oaks (2002)

    Google Scholar 

  17. Giorgi, A.: The descriptive phenomenological method in psychology: A modified husserlian approach. Duquesne University Press, Pittsburgh (2009)

    Google Scholar 

  18. Anderson, K.D.: Targeting recovery: priorities of the spinal cord-injured population. J. Neurotrauma 21, 1371–1383 (2004)

    Article  PubMed  Google Scholar 

  19. Charlifue, S.W., Gerhart, K.A., Menter, R.R., Whiteneck, G.G., Scott Manley, M.: Sexual issues of women with spinal cord injuries. Paraplegia 30, 192–199 (1992)

    Article  PubMed  Google Scholar 

  20. Sipski, M.L., Alexander, C.J.: Sexual activities, response and satisfaction in women pre- and post-spinal cord injury. Arch. Phys. Med. Rehabil. 74, 1025–1029 (1993)

    Article  PubMed  Google Scholar 

  21. Courtois, F., Rodrigue, X., Côté, I., Boulet, M., Vézina, J.G., Charvier, K., Dahan, V.: Sexual function and autonomic dysreflexia in men with spinal cord injuries: how should we treat? Spinal Cord. 50, 869–877 (2012)

  22. Courtois, F., Charvier, K., Leriche, A., Vézina, J.G., Côté, M., Bélanger, M.: Blood pressure changes during sexual stimulation, ejaculation and midodrine treatment in spinal cord injured men. Br. J. Urol. 101, 331–337 (2008)

    Article  Google Scholar 

  23. Courtois, F., Charvier, K., Leriche, A., Vézina, J.G., Côté, I., Raymond, D., Jacquemin, G., Fournier, C., Bélanger, M.: Perceived physiological and orgasmic sensations at ejaculation in spinal cord injured men. J. Sex. Med. 5, 2419–2430 (2008)

    PubMed  Google Scholar 

  24. Courtois, F., Charvier, K., Vézina, J.G., Morel-Journel, N., Carrier, S., Jacquemin, G., Côté, I.: Assessing and conceptualizing orgasm following a spinal cord injury. Br. J. Urol. 108, 1624–1633 (2011)

    Article  Google Scholar 

  25. Reeses, P.M., Fowler, C.J., Paas, C.P.: Sexual function in men and women with neurological disorders. The Lancet. 369, 512–525 (2007)

    Article  Google Scholar 

  26. Komisaruk, B.R., Wise, N., Frangos, E., Wen-Ching, L., Allen, K., Brody, S.: Women’s clitoris, vagina, and cervix mapped on the sensory cortex: fMRI evidence. J. Sex. Med. 8, 2822–2830 (2011)

    Article  PubMed Central  PubMed  Google Scholar 

  27. Benevento, B.T., Sipski, M.L.: Neurogenic bladder, neurogenic bowel, and sexual dysfunction in people with spinal cord injury. Phys. Ther. 82, 601–612 (2002)

    PubMed  Google Scholar 

  28. Ford, A.B., Orfirer, A.P.: Sexual behaviour and chronically ill patient. Med. Asp. Human Sex. 10, 51–61 (1967)

    Google Scholar 

  29. PVA Sexuality and reproductive Health in Adults with spinal cord injury: A clinical Practice Guideline for Health-Care Professionals. Consortium for Spinal Cord Medicine. Paralyzed Veterans of America, 2010

  30. Ekland, M., Lawrie, B.: How a woman’s sexual adjustment after sustaining spinal cord injury impacts sexual health interventions. SCI Nurs. 21(1), 14–19 (2004)

    PubMed  Google Scholar 

  31. Middleton, JW., De Wolf, A., Cameron, ID., Elliott, S., McBride, K., Breen, S., Abramson, C.: Sexual Health Following Spinal Cord Injury. In: Eng JJ, Teasell, RW, Miller, WC, Wolfe, DL, Townson, AF, Hsieh, JTC, Connolly, SJ, Mehta, S, and Sakakibara, BM, editors. Spinal Cord Injury Rehabilitation Evidence. Version 3.0. Vancouver: 2010; p 1–67

  32. McBride, K.E., Rines, B.: Sexuality and spinal cord injury: a road map for nurses. SCI Nurs. 17, 8–13 (2007)

    Google Scholar 

  33. Madorsky, J.G.B., Dixon, T.P.: Rehabilitation aspects of human sexuality. West J. Med. 139, 174–176 (1983)

    PubMed Central  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David Ditor.

Appendix

Appendix

See Table 5.

Table 5 Interview guide

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cramp, J., Courtois, F., Connolly, M. et al. The Impact of Urinary Incontinence on Sexual Function and Sexual Satisfaction in Women with Spinal Cord Injury. Sex Disabil 32, 397–412 (2014). https://doi.org/10.1007/s11195-014-9354-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11195-014-9354-8

Keywords

Navigation