Spinal kord yaralanmalı hastalarda cinsel fonksiyon bozuklukları ve nörolojik düzey ile ilişkileri
Küçük Resim Yok
Tarih
2006
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Spinal kord yaralanmalı hastalarda cinsel fonksiyon bozukluklarının hasta bildirimleri ile ortaya konması ve nörolojik muayene bulgularıyla ilişkilerinin araştırılması. Gereç ve Yöntem: Çalışmaya spinal şok döneminden çıkmış, 30'u erkek, 13'ü kadın toplam 43 hasta alındı. Anket yoluyla hastaların yaralanma sonrası cinsel fonksiyonları hakkında ayrıntılı bilgi edinildi. Erektil fonksiyon; International Index of Erectile Function-5 (IIEF-5) ile, kadın cinsel fonksiyonu Female Sexual Function Index (FSFI) ile değerlendirildi. Nörolojik düzey American Spinal Injury Association (ASIA) protokolüne göre belirlendi. Bu seviyeler, cinsel fonksiyondan sorumlu spinal kord merkezlerinin yerleşimine göre T10 ve üzeri, T11-L2 arası, konus ve kauda olmak üzere 4 grupta sınıflanarak ereksiyon, ejakülasyon ve orgazmla ilgili bilgilerle nörolojik düzey arasındaki ilişkiler araştırıldı. Bulgular: Erkeklerde ortalama IIEF-5 skoru 7±6,69 idi. T10 ve üzerindeki seviyelerde refleks ereksiyonların %100 oranında korunduğu; konus-kauda lezyonlarında ise psikojen ereksiyonlar %100 oranında korunurken, refleks ereksiyonların olmadığı bulundu. Hastaların %43,3'ünde ejakülasyon korunmuştu. Ejakülasyon oranı T10 ve üzeri seviyelerde konus-kauda seviyelerine göre daha düşüktü. Konus-kauda lezyonu olan hastaların %83,3'ünde, bu düzeyin üzerindeki hastaların %54,5'inde orgazm mevcuttu. Kadınlarda ortalama FSFI skoru: 2,35±0,94 idi. Kadınlarda az sayıda hastada veri elde edebilmekle birlikte, konus-kauda lezyonu olan hastaların %83,3'ünde psikojen lubrikasyon korunurken, refleks lubrikasyonun olmadığı belirlendi. Bilgi edinilebilen hastalarda orgazm bozukluğu mevcuttu. Sonuç: Bu çalışma, spinal kord yaralanmalı hastalarda nörolojik düzeyin cinsel fonksiyonu düzenleyen merkezler esas alınarak sınıflanmasının geride kalan cinsel kapasitenin tahmininde önemli olduğunu göstermiştir.
Objective: To determine sexual dysfunction and its association with neurological examination findings in spinal cord injured patients. Materials and Methods: Forty-three patients (30 men, 13 women) who were out of the spinal shock period were enrolled to the study. Information about the post-injury sexual functions was obtained via questionnaires. Erectile function was evaluated by International Index of Erectile Function-5 (IIEF-5), women sexual function was evaluated with Female Sexual Function Index (FSFI). Neurological level was determined according to American Spinal Injury Association (ASIA) impairment scale. These levels were classified into 4 groups, namely, T10 and above, T11-L2, conus, and cauda according to the alignment of the spinal cord centers responsible of sexual function. The relations between the data about erection, ejaculation, lubrication and orgasm, and neurological level were investigated. Results: Mean IIEF-5 score in men was 7±6.69. It was found that at levels of T10 and above; reflex erections were preserved with a 100% ratio. At conus-cauda lesions; while psychogenic erections were preserved with a 100% ratio, reflex erections were absent. In all patients with neurologic levels at or below T12, psychogenic erections were present. Ejaculation was present in 43.3% of men. Ejaculation rate was lower in T10 and above levels when compared with that in conus-cauda levels. Orgasm was present in 83.3% of the patients with conus-cauda lesions, and 54.5% of the patients with lesions above this level. Mean FSFI score in women was 2.35±0.94. Despite the lack of sufficient data in women, it was determined that in 83.3% of the patients with conus-cauda lesions, psychogenic lubrication was preserved while reflex lubrication was not. Orgasmic disorder was noteworthy in this limited sample of female patients. Conclusion: This study has demonstrated there is impairment in sexual dysfunction in both sex after spinal cord injury and that the classification of neurological level according to the spinal centers regulating sexual function in spinal cord injured patients has an imperative place in the estimation of the remaining sexual function.
Objective: To determine sexual dysfunction and its association with neurological examination findings in spinal cord injured patients. Materials and Methods: Forty-three patients (30 men, 13 women) who were out of the spinal shock period were enrolled to the study. Information about the post-injury sexual functions was obtained via questionnaires. Erectile function was evaluated by International Index of Erectile Function-5 (IIEF-5), women sexual function was evaluated with Female Sexual Function Index (FSFI). Neurological level was determined according to American Spinal Injury Association (ASIA) impairment scale. These levels were classified into 4 groups, namely, T10 and above, T11-L2, conus, and cauda according to the alignment of the spinal cord centers responsible of sexual function. The relations between the data about erection, ejaculation, lubrication and orgasm, and neurological level were investigated. Results: Mean IIEF-5 score in men was 7±6.69. It was found that at levels of T10 and above; reflex erections were preserved with a 100% ratio. At conus-cauda lesions; while psychogenic erections were preserved with a 100% ratio, reflex erections were absent. In all patients with neurologic levels at or below T12, psychogenic erections were present. Ejaculation was present in 43.3% of men. Ejaculation rate was lower in T10 and above levels when compared with that in conus-cauda levels. Orgasm was present in 83.3% of the patients with conus-cauda lesions, and 54.5% of the patients with lesions above this level. Mean FSFI score in women was 2.35±0.94. Despite the lack of sufficient data in women, it was determined that in 83.3% of the patients with conus-cauda lesions, psychogenic lubrication was preserved while reflex lubrication was not. Orgasmic disorder was noteworthy in this limited sample of female patients. Conclusion: This study has demonstrated there is impairment in sexual dysfunction in both sex after spinal cord injury and that the classification of neurological level according to the spinal centers regulating sexual function in spinal cord injured patients has an imperative place in the estimation of the remaining sexual function.
Açıklama
Anahtar Kelimeler
Rehabilitasyon
Kaynak
Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
52
Sayı
4
