Impact of spinal injury with neurological consequences on sexual function: Sexual dysfunctions in men

Sexual impairment and decreased fertility constitute a part of a complex dysfunction typical for men with spinal injury with neurological consequences (SINC). Despite the progress in medical sciences and quality of care provided for disabled persons, the problem is often neglected by medical professionals and caregivers.Aim of the study: Presentation of patophysiological background and specificity of sexual dysfunction typical for men following SINC. Review of contemporary treatment modalities designed for erectile dysfunction and infertility in men after SINC.Method: Literature review, authors’ clinical experience.Results and conclusions: Specific neurological deficit with overlapping adaptation problems and depression account for erectile dysfunction in men after SINC. There is a wide range of efficient therapies addressed to patients suffering from erectile disturbances resulting from SINC. Selection of a proper therapy depends on location (level) of the lesion of a neural structure, type of deficit, functional status, presence of symptoms of autonomic dysreflexia, concomitant diseases and patient’s individual preferences. Patient’s awareness of the disability and positive attitude towards acceptance of alternative forms of sexual expressions are crucial for the therapeutic success. Ejaculation dysfunction and infertility are common among men after SINC. Application of contemporary methods of assisted reproduction may be efficient in about half of male population with SINC.