Sexual and Fertility Concerns

  • D. A. Ohl
  • C. J. Bennett
  • C. A. Glass
Part of the Clinical Practice in Urology book series (PRACTICE UROLOG)


Society tends to think of the disabled person as asexual (Cole 1975a). This is not true. The majority of spinal cord injured (SCI) patients are young and they tend to have young partners. Because of this, sexuality and fertility potential are of great concern. In this chapter we will review the sexual and fertility capabilities of the SCI patient and discuss techniques which may be used to improve them.


Spinal Cord Injury Sexual Arousal Spinal Cord Injure Spinal Cord Injury Patient Spinal Trauma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Anderson TP, Cole TM (1975) Sexual counselling of the physically disabled. Postgrad Med 58: 117–123PubMedGoogle Scholar
  2. Bennett CJ, Ayers JWT, Randolph JF et al. (1987a) Electroejaculation of paraplegic males followed by pregnancies. Fertil Steril 48: 1070–1072PubMedGoogle Scholar
  3. Bennett CJ, Seager SWJ, McGuire EJ (1987b) Electroejaculation for recovery of semen after retroperitoneal lymph node dissection: case report. J Urol 137: 513–515PubMedGoogle Scholar
  4. Bensman A, Kottke FJ (1966) Induced emission of sperm utilizing electrical stimulation of the seminal vesicles and vas deferens. Arch Phys Med Rehabil 47: 436–443PubMedGoogle Scholar
  5. Benson GS, McConnell JA, Schmidt WA (1981) Penile polsters: functional structures or atherosclerotic changes? J Urol 125: 800–803PubMedGoogle Scholar
  6. Bodner DR, Lindan R, Leffler E, Kursh ED, Resnick MI (1987) The application of intracavernous injection of vasoactive medications for erection in men with spinal cord injury. J Urol 138: 310–311PubMedGoogle Scholar
  7. Bors E, Comarr AE (1960) Neurologic disturbance of sexual function with special reference to 529 patients with spinal cord injury. Urol Surv 10: 191–222Google Scholar
  8. Bors E, Engle ET, Rosenquist RC, Holliger VH (1950) Fertility in paraplegic males — a preliminary report of endocrine studies. J Clin Endocrinol 10: 381–398CrossRefGoogle Scholar
  9. Brindley GS (1981) Electroejaculation: its technique, neurological implications and uses. J Neurol Neurosurg Psychiatry 44: 9–18PubMedCrossRefGoogle Scholar
  10. Brindley GS (1982) Deep scrotal temperature and the effect on it of clothing, air temperature, activity, posture and paraplegia. Br J Urol 54: 49–55PubMedCrossRefGoogle Scholar
  11. Brindley GS (1983) Cavernosal alpha-blockage: a new technique for investigating and treating erectile impotence. Br J Psychiatry 143: 332–334PubMedCrossRefGoogle Scholar
  12. Brindley GS (1984) The fertility of men with spinal injuries. Paraplegia 22: 337–348PubMedCrossRefGoogle Scholar
  13. Catanzarite VA, Ferguson JE, Weinstein CS (1984) Clinical management of spinal cord injury. Obstet Gynecol 64: 598–599 letterGoogle Scholar
  14. Chapelle PA, Blanquart F, Puech AJ, Held JP (1983) Treatment of anejaculation in the total paraplegic by subcutaneous injection of physostigmine. Paraplegia 21: 30–36PubMedCrossRefGoogle Scholar
  15. Cole TM (1975a) Sexuality and physical disabilities. Arch Sex Behav 4: 389–403PubMedCrossRefGoogle Scholar
  16. Cole TM (1975b) Reaction of the rehabilitation team to patients with sexual problems. Arch Phys Med Rehabil 56: 10–11PubMedGoogle Scholar
  17. Cole TM, Stevens MR (1975) Rehabilitation professionals and Sexual Counseling for Spinal Cord Injured Adults. Arch Sex Behav 4: 631–638PubMedCrossRefGoogle Scholar
  18. Cole TM, Chilgren R, Rosenberg P (1973) A new programme of sex education and counselling for spinal cord injured adults and health care professionals. Paraplegia 11: 111–124PubMedCrossRefGoogle Scholar
  19. Comarr AE (1966) Observations on menstruation and pregnancy among female spinal cord injury patients. Paraplegia 3: 263–271PubMedCrossRefGoogle Scholar
  20. Comarr AE (1970) Sexual function among patients with spinal cord injury. Urol Int 25: 134–168PubMedCrossRefGoogle Scholar
  21. Comarr AE (1971) Sexual concepts in traumatic cord and cauda equina lesions. J Urol 106: 375–378PubMedGoogle Scholar
  22. Conine TA, Disher CS, Gilmore SL, Fischer BAP (1979) Physical therapists’ knowledge of sexuality of adults with spinal cord injury. Phys Ther 59: 395–398PubMedGoogle Scholar
  23. Conti G (1952) Erection of the human penis and its morphological-vascular bases (in French). Acta Anat (Basel) 14: 217–262CrossRefGoogle Scholar
  24. David A, Ohry A, Rozin R (1977) Spinal cord injuries: male fertility aspects. Paraplegia 15: 11–14PubMedCrossRefGoogle Scholar
  25. Deyoe FS (1972) Marriage and family patterns with long-term spinal cord injury. Paraplegia 10: 219–224PubMedCrossRefGoogle Scholar
  26. Domer FR, Wessler G, Brown RL, Charles HC (1978) Involvement of the sympathetic nervous system in the urinary bladder internal sphincter and in penile erection in the anesthetized cat. Invest Urol 15: 404–407PubMedGoogle Scholar
  27. Dorr LD, Brody MJ (1967) Hemodynamic mechanism of erection in the canine penis. Am J Physiol 213: 1526–1531PubMedGoogle Scholar
  28. Eckhardt C (1863) Quoted in Siroky and Krane (1983)Google Scholar
  29. Francois N, Maury M, Jouannet D, David G, Vacant J (1978) Electroejacuation of a complete paraplegic followed by pregnancy. Paraplegia 16: 248–251PubMedCrossRefGoogle Scholar
  30. Francois N, Lichtenberger JM, Jouannet P, Desert JF, Maury M (1980) L’éjaculation par le vibromassage chez le paraplegique à propos de 50 cas avec 7 grossesses. Ann Med Phys 23: 24–36Google Scholar
  31. Frankel HL, Mathias CJ, Walsh JJ (1974) Blood pressure, plasma catecholamines and prostaglandins during artificial erection in a male tetraplegic. Paraplegia 12: 205–211PubMedCrossRefGoogle Scholar
  32. Goller H, Paeslack V (1972) Pregnancy damage and birth-complications in the children of paraplegic women. Paraplegia 10: 213–217PubMedCrossRefGoogle Scholar
  33. Green BG, Sloan SL (1986) Penile prosthesis in spinal cord injured patients: combined psychosexual counselling and surgical regimen. Paraplegia 24: 167–172PubMedCrossRefGoogle Scholar
  34. Greenspoon JS, Paul RH (1986) Paraplegia and quadriplegia: special considerations during pregnancy and labor and delivery. Am J Obstet Gynecol 155: 738–741PubMedGoogle Scholar
  35. Grynbaum BB, Kaplan LI, Lloyd KE (1963) Quoted in Teal JC, Athelstan GT (1975) Sexuality and spinal cord injury: some psychosocial considerations. Arch Phys Med Rehabil 56: 264–268Google Scholar
  36. Guttman L (1964) The married life of paraplegics and tetraplegics. Paraplegia 2: 182–188CrossRefGoogle Scholar
  37. Guttman L, Walsh JJ (1971) Prostigmine assessment of fertility in spinal man. Paraplegia 9: 39–51CrossRefGoogle Scholar
  38. Guttman L, Frankel HL, Paeslack V (1965) Cardiac irregularities during labour in paraplegic women. Paraplegia 3: 144–151CrossRefGoogle Scholar
  39. Halsted LS, Halsted MG, Salhoot JT, Stock DD, Sparks RW (1978) Sexual attitudes, behavior and satisfaction for able-bodied and disabled participants attending workshops in human sexuality. Arch Phys Med Rehabil 59: 497–501Google Scholar
  40. Hayes PJ, Krishnan KR, Diver MJ, Hipkin LF, Davis JC (1979) Testicular endocrine function in paraplegic men. Clin Endocrinol 11: 549–552CrossRefGoogle Scholar
  41. Horne HW, Paull DP, Munro D (1948) Fertility studies in the human male with traumatic injuries of the spinal cord and cauda equina. N Engl J Med 239: 959–961PubMedCrossRefGoogle Scholar
  42. Jackson RW (1972) Sexual rehabilitation after cord injury. Paraplegia 10: 10–55CrossRefGoogle Scholar
  43. Karacan I, Aslan C, Hirshkowitz M (1983) Erectile mechanisms in man. Science 220: 1080–1082PubMedCrossRefGoogle Scholar
  44. Kedia KR (1983) Ejaculation and emission: normal physiology, dysfunction and therapy. In: Krane RJ, Siroky MB, Goldstein I (eds) Male sexual dysfunction. Little Brown, Boston, pp 37–51Google Scholar
  45. Kedia KR, Markland C, Fraley EE (1975) Sexual function following high retroperitoneal lymphadenectomy. J Urol 114: 237–239PubMedGoogle Scholar
  46. Kikuchi TA, Skowsky WR, El-Toraei I, Swerdloff R (1976) The pituitary-gonadal axis in spinal cord injury. Fertil Steril 27: 1142–1145PubMedGoogle Scholar
  47. King NJ, Klein RM, Remenyi AG (1985) Sexual counselling with spinal cord injured persons. Aust Fam Physician 14: 47–51PubMedGoogle Scholar
  48. Krane RJ, Siroky MB (1981) Neurophysiology of erection. Urol Clin North Am 8: 91–102PubMedGoogle Scholar
  49. Leriche A, Berard E, Vauzelle JL et al. (1977) Histological and hormonal testicular changes in spinal cord patients. Paraplegia 15: 274–279PubMedCrossRefGoogle Scholar
  50. Light JK, Scott FB (1981) Management of neurogenic impotence with inflatable penile prosthesis. Urology 17: 341–343PubMedCrossRefGoogle Scholar
  51. Madorsky JGB, Dixon TP (1983) Rehabilitation aspects of human sexuality. West J Med 139: 174–176PubMedGoogle Scholar
  52. Martin, DE, Warner H, Crenshaw TL, Crenshaw RT, Shapiro CE, Perkash I (1983) Initiation of erection and semen release by rectal probe electrostimulation (RPE). J Urol 129: 637–642PubMedGoogle Scholar
  53. Morales PA, Hardin J (1958) Scrotal and testicular temperature studies in paraplegics. J Urol 79: 972–975PubMedGoogle Scholar
  54. Morley JE, Distiller LA, Lissoos I et al. (1979) Testicular function in patients with spinal cord damage. Horm Metab Res 11: 679–682PubMedCrossRefGoogle Scholar
  55. Munro D, Horne HW, Pauli DP (1948) The effect of injury to the spinal cord and cauda equina on the sexual potency of men. N Engl J Med 239: 903–911PubMedCrossRefGoogle Scholar
  56. Newman HF, Northrup JD (1981) Mechanisms of human penile erection: an overview. Urology 17: 399–408PubMedCrossRefGoogle Scholar
  57. Nilsson S, Obrant KO, Persson PS (1968) Changes in the testis parenchyma caused by acute nonspecific epididymitis. Fertil Steril 19: 748–757PubMedGoogle Scholar
  58. Ohry A, Peleg D, Goldman J, David A, Rozin R (1978) Sexual function, pregnancy and delivery in spinal cord injured women. Gynecol Obstet Invest 9: 281–291PubMedCrossRefGoogle Scholar
  59. Ottesen B, Wagner G, Virag R, Fahrenkrug J (1984) Penile erection: possible role for vasoactive intestinal polypeptide as a neurotransmitter. Br Med J 288: 9–11CrossRefGoogle Scholar
  60. Perkash I, Martin DE, Warner H, Blank MS, Collins DC (1985) Reproductive biology of paraplegics: results of semen collection, testicular biopsy and serum hormone evaluation. J Urol 134: 284–288PubMedGoogle Scholar
  61. Phelps G, Brown M, Chen J et al. (1983) Sexual experience and plasma testosterone levels in male veterans after spinal cord injury. Arch Phys Med Rehabil 64: 47–52PubMedGoogle Scholar
  62. Robertson DNS (1972) Pregnancy and labour in the paraplegic. Paraplegia 10: 209–212PubMedCrossRefGoogle Scholar
  63. Root WS, Bard P (1947) The mechanism of feline erection through sympathetic pathways with some remark on sexual behavior after deafferentation of the genitalia. Am J Physiol 150: 80–90Google Scholar
  64. Rossier AB, Fam BA (1984) Indication and results of semirigid penile prostheses in spinal cord injury patients: long term followup. J Urol 131: 59–62PubMedGoogle Scholar
  65. Rossier AB, Ziegler WH, Duchosal PW, Meylan J (1971) Sexual function and dysreflexia. Paraplegia 9: 51–59PubMedCrossRefGoogle Scholar
  66. Sarkarati M, Rossier AB, Fam BA (1987) Experience in vibratory and electroejaculation techniques in spinal cord injury patients: a preliminary report. J Urol 138: 59–62PubMedGoogle Scholar
  67. Sidi AA, Cameron JS, Duffy LM, Lange PH (1986) Intracavernous drug-induced erections in the management of male erectile dysfunction: experience with 100 patients. J Urol 135: 704–706PubMedGoogle Scholar
  68. Sidi AA, Cameron JS, Dyksta DD, Reinberg Y, Lange PH (1987) Vasoactive intracavernous pharmacotherapy for the treatment of erectile impotence in men with spinal cord injury. J Urol 138: 539–542PubMedGoogle Scholar
  69. Siroky MB, Krane RJ (1983) Neurophysiology of erection. In: Krane RJ, Siroky MB, Goldstein I (eds) Male sexual dysfunction. Little Brown, Boston, pp 9–20Google Scholar
  70. Sobrero AJ, Stearns HE, Blari JH (1965) Technic for the induction of ejaculation in humans. Fertil Steril 16: 765–767PubMedGoogle Scholar
  71. Spielman FJ (1984) Parturient with spinal cord transection: complications of autonomic hyperreflexia. Obstet Gynecol 64: 147PubMedGoogle Scholar
  72. Spira R (1956) Artificial insemination after intrathecal injection of neostigmine in a paraplegic. Lancet 1: 670–671CrossRefGoogle Scholar
  73. Talbot HS (1955) The sexual function in paraplegia. J Urol 73: 91–100PubMedGoogle Scholar
  74. Talbot HS (1971) Psychosocial aspects of sexuality in spinal cord injury patients. Paraplegia 9: 37–39PubMedCrossRefGoogle Scholar
  75. Thomas AJ (1983) Ejaculatory dysfunction. Fertil Steril 39: 445–454PubMedGoogle Scholar
  76. Thomas RJS, McLeish G, McDonald IA (1975) Electroejaculation of the paraplegic male followed by pregnancy. Med J Aust 2: 798–799Google Scholar
  77. Tsuji I, Nakajima F, Morimoto J, Nounada Y (1961) The sexual function in patients with spinal cord injury. Urol Int 12: 270–280PubMedCrossRefGoogle Scholar
  78. Wagenknect LF (1985) Causes of obstruction of the male reproductive tract. In: Wagenknect LF (ed) Microsurgery in urology. Thieme, New YorkGoogle Scholar
  79. Weinberg JS (1982) Human sexuality and spinal cord injury. Neurosurg Clin North Am 17: 407–419Google Scholar
  80. VanArsdalen KN, Klein FA, Hackler RH, Brady SM (1981) Penile implants in spinal cord injury patients for maintaining external appliances. J Urol 126: 331–332Google Scholar
  81. Virag R (1982) Intracavernous injection of papavarine for erectile failure. Lancet 2: 938 (letter)PubMedCrossRefGoogle Scholar
  82. Virag R, Frydman D, Legman M, Virag H (1984) Intracavernous injection of papaverine as a diagnostic and therapeutic method in erectile failure. Angiology 35: 79–87PubMedCrossRefGoogle Scholar
  83. Young BK, Katz M, Klein SA (1983) Pregnancy after spinal cord injury: altered maternal and fetal response to labor. Obstet Gynecol 62: 59–63PubMedGoogle Scholar
  84. Zeitlin AB, Cottrell TL, Lloyd FA (1957) Sexology of the paraplegic male. Fertil Steril 8: 337–344PubMedGoogle Scholar
  85. Abrams K (1981) The impact on marriages of adult-onset paraplegia. Paraplegia 19: 253–259PubMedCrossRefGoogle Scholar
  86. Amelar R, Dubin L (1982) Sexual function and fertility in paraplegic males. Urology 20: 62–64PubMedCrossRefGoogle Scholar
  87. Bandura A (1969) Principles of behaviour modification. Holt, Rinehart and Winston, New YorkGoogle Scholar
  88. Bardlach J, Anderson F (1979) Sexual therapy in rehabilitation. In: Murray R, Kijek J (eds) Current perspectives in rehabilitation nursing. Mosby, St Louis, pp 188–206Google Scholar
  89. Barlow D, Becker J, Leitenberg H, Agras W (1970) A mechanical strain gauge for recording penile circumference change. J Appl Behav Anal 3: 73–76PubMedCrossRefGoogle Scholar
  90. Beard H, Sampson T (1981) Denial and objectivity in haemodialysis patients: adjustment by opposite mechanisms. In: Levy N (ed) Psychonephrology 1. Plenum, New York, pp 169–176Google Scholar
  91. Beck J, Sakheim D, Barlow D (1983) Operating characteristics of the vaginal photoplethysmograph: some implications for its use. Arch Sex Behav 12: 43–58PubMedCrossRefGoogle Scholar
  92. Benson G, Lipshultz L, McConnell J (1983) Mechanisms of human erection, emission and ejaculation: current clinical concepts. In: Zorgniotti A (ed) Vasculogenic impotence. Thomas, Springfield, Illinois, pp 71–86Google Scholar
  93. Bors E, Comarr A (1960) Neurological disturbance of sexual function. Urol Surv 10: 191–222Google Scholar
  94. Brady J (1969) Brevital relaxation treatment of frigidity. Behav Res Ther 4: 71–77CrossRefGoogle Scholar
  95. Bregman S (1975) Sexuality and the spinal cord injured woman. Sister Kenny Institute, MinneapolisGoogle Scholar
  96. Brindley G (1981) Reflex ejaculation under vibratory stimulation in paraplegic men. Paraplegia 19: 300–303CrossRefGoogle Scholar
  97. Brindley G (1984) The fertility of men with spinal injuries. Paraplegia 22: 237–245CrossRefGoogle Scholar
  98. Brindley G, Rushton D, Craggs M (1974) The pressure exerted by the external sphincter of the urethra when its motor nerve fibres are stimulated electrically. Br J Urol 46: 453–462PubMedCrossRefGoogle Scholar
  99. Clement V, Schmidt G (1983) The outcome of couple therapy for sexual dysfunctions using three different formats. J Sex Marital Ther 9: 67–79PubMedGoogle Scholar
  100. Comarr A (1966) Observations on menstruation and pregnancy among female spinal cord injury patients. Paraplegia 3: 263–272PubMedCrossRefGoogle Scholar
  101. Conine T (1984) Sexual rehabilitation: the roles of allied health professionals. In: Kreuger D (ed) Rehabilitation psychology: a comprehensive textbook, Aspen System Corporation, Rockville, pp 124–158Google Scholar
  102. Cooper A (1969) Disorders of sexual potency in the male: a clinical and statistical study of some factors related to short-term prognosis. Br J Psychiatry 115: 709–719PubMedCrossRefGoogle Scholar
  103. Fink S, Skipper J, Hallenbeck P (1969) Physical disability and problems in marriage. J Mar Fam 30: 64–74CrossRefGoogle Scholar
  104. Fisher C, Gross J, Zurch J (1965) Cycles of penile erection synchronous with dreaming (REM) sleep. Arch Gen Psychiatry 12: 29–45PubMedCrossRefGoogle Scholar
  105. Fisher C, Schiavi R, Edwards A (1976) Assessment of nocturnal REM erection in differential diagnosis of sexual impotence. Sleep Res 5: 42Google Scholar
  106. Fisher C, Schiavi R, Edwards A (1979) Evaluations of nocturnal penile tumescence in the differential diagnosis of sexual impotence: a quantitative study. Sleep Res 6: 431–437Google Scholar
  107. Fisher C, Cohen H, Shiavi R et al. (1983) Patterns of female sexual arousal during sleep and waking: vaginal thermo-conductance studies. Arch Sex Behav 12: 97–122CrossRefGoogle Scholar
  108. Fisher S (1973) The female orgasm. Basic Books, New YorkGoogle Scholar
  109. Francois N, Lichtenberger J, Jouannet P, Desert J, Maury M (1980) Ejaculation by vibromassage in paraplegies: report of 50 cases with 7 pregnancies (in French). Ann Med Phys 23: 24–36Google Scholar
  110. Franks C, Wilson G (eds) (1974) Annual review of behaviour therapy: theory and practice. Bruner/Mazel, New YorkGoogle Scholar
  111. Freund K, Sedlacek F, Knob K (1965) A simple transducer for mechanical plethysmography of the male genitalia. J Exp Anal Behav 8: 169–170PubMedCrossRefGoogle Scholar
  112. Geer J, Morokoff P, Greenwood P (1974) Sexual arousal in women: the development of a measurement device for vaginal blood volume. Arch Sex Behav 3: 559–564PubMedCrossRefGoogle Scholar
  113. Glass C (1989) An investigation of some psychological factors of importance in the assessment and treatment of secondary impotence in dialysis and transplant patients. PhD thesis, University of LiverpoolGoogle Scholar
  114. Glass C, Fielding D, Evans C, Ashcroft J (1988) Factors related to sexual functioning in male patients undergoing haemodialysis and with kidney transplants. Arch Sex Behav 16: 189–207CrossRefGoogle Scholar
  115. Gutmann L (1964) The married life of paraplegics and tetraplegics. Paraplegia 2: 182–188CrossRefGoogle Scholar
  116. Jehu D (1979) Sexual dysfunction: a behavioural approach to causation, assessment and treatment. Wiley, New YorkGoogle Scholar
  117. Kaplan H (1974) The new sex therapy: active treatment of sexual dysfunctions. Bruner/Mazel, New YorkGoogle Scholar
  118. Karacan I (1969) A simple and inexpensive transducer for quantitative measurement of penile erection during sleep. Behav Res Methodol Inst 1: 251–252CrossRefGoogle Scholar
  119. Karacan I (1970) Clinical value of nocturnal erection in the prognosis and diagnosis of impotence. Med Asp Hum Sex 4: 27–34Google Scholar
  120. Karacan I, Catesby Ware J, Dervent B et al. (1978) Impotence and blood pressure in the flaccid penis: relationship to nocturnal penile tumescence. Sleep 1: 125–132PubMedGoogle Scholar
  121. Kilmann P (1978) The treatment of female orgasmic dysfunction: a methodological review of the literature since 1970. J Sex Marital Ther 4: 155–176PubMedCrossRefGoogle Scholar
  122. Kinsey A, Pomeroy W, Martin C, Gebhard P (1953) Sexual behavior in the human female. Saunders, PhiladelphiaGoogle Scholar
  123. Lamid S (1985) Nocturnal penile tumescence studies in spinal cord injured males. Paraplegia 23: 26–31Google Scholar
  124. LoPiccolo L, Heiman J (1978) Sexual assessment and history interview. In: LoPiccolo J, LoPiccolo L (eds) Handbook of sex therapy. Plenum, New York, pp 233–238CrossRefGoogle Scholar
  125. Marshall P, Surridge D, Delva N (1981) The role of nocturnal penile tumescence in differentiating between organic and psychogenic impotence — the first stage of validation. Arch Sex Behav 20: 1–10CrossRefGoogle Scholar
  126. Masters W, Johnson V (1966) Human sexual response. Little Brown, BostonGoogle Scholar
  127. Masters W, Johnson V (1970) Human sexual inadequacy. Little Brown, BostonGoogle Scholar
  128. McCarthy B (1973) A modification of Masters and Johnson’s sex therapy model in a clinical setting. Psychother Theor Res Prac 10: 290–293CrossRefGoogle Scholar
  129. Money J (1960) Phantom orgasm in the dreams of paraplegic men and women. Arch Gen Psychiatry 3: 373–382PubMedCrossRefGoogle Scholar
  130. Nagler B (1950) Psychiatric aspects of cord injury. Am J Psychiatry 107: 49–56PubMedGoogle Scholar
  131. Ohlmeyer P, Brilmeyer H, Hullstrung H (1944) Periodische Vorgauge in Schlaf. Pfluegers Arch Ges Physiol 248: 559–560CrossRefGoogle Scholar
  132. Polack J, Gu J, Mina S, Bloom S (1981) Vipergic nerves in the penis. Lancet 2: 217–219CrossRefGoogle Scholar
  133. Ryan J (1961) Dreams of paraplegics. Arch Gen Psychiatry 5: 94CrossRefGoogle Scholar
  134. Schuler M (1982) Sexual counselling for the spinal cord injured: a review of five programmes. J Sex Marital Ther 8: 241–252PubMedCrossRefGoogle Scholar
  135. Shambaugh P, Hampers P, Bailey G, Snyder D, Merril J (1967) Haemodialysis in the home: emotional impact on the spouse. Trans Am Soc Artif Intern Organs 13: 41–45Google Scholar
  136. Sha’ked A, Flynn R (1978) Normative sexual behaviour and the person with a disability: training of rehabilitation personnel. J Rehabil 44: 30–36Google Scholar
  137. Trieschmann R (ed) (1980) Spinal cord injuries: psychological, social and vocational adjustment. Pergamon Press, New YorkGoogle Scholar
  138. Virag R, Virag H, Lajujie M (1985) A new device for measuring penile rigidity. Urology 25: 80–81PubMedCrossRefGoogle Scholar
  139. Wagner G (1981) Erection: physiology and endocrinology. In: Wagner G, Green R (eds) Impotence: physiological, psychological and surgical diagnosis and treatment. Plenum, New York, pp 25–36Google Scholar
  140. Wasserman M, Pollak C, Spielman A, Weitzman E (1980) The differential diagnosis of impotence: the measurement of nocturnal penile tumescence. J Am Med Assoc 243: 2038–2042CrossRefGoogle Scholar
  141. Weiss H (1972) The physiology of human penile erection. Ann Intern Med 76: 793–799PubMedCrossRefGoogle Scholar
  142. Wolpe J (1958) Psychotherapy by reciprocal inhibition. Stanford University Press, CaliforniaGoogle Scholar
  143. Wolpin M (1969) Guided imagining to reduce avoidance behaviour. Psychother Theor Res Prac 6: 122–125CrossRefGoogle Scholar
  144. Zuckerman M (1971) Physiological measurement of sexual arousal in the human. Psychol Bull 75: 297–329PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 1991

Authors and Affiliations

  • D. A. Ohl
  • C. J. Bennett
  • C. A. Glass

There are no affiliations available

Personalised recommendations