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  • Review Article
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Sexual function is the most commonly investigated aspect of sexuality in individuals with spinal cord injury or disease – a systematic review

Spinal Cord volume 63, pages 523–529 (2025)Cite this article

Subjects

Abstract

Study design

Systematic review.

Objectives

To create an overview of standardized assessments to evaluate sexuality after SCI/D in a systematic literature review. Furthermore, we explored the various dimensions of sexuality assessed by these tools and analyzed sex and gender differences.

Methods

In a systematic review (PROSPERO CRD42023416855), we reviewed published assessments of sexuality in individuals with SCI/D with a focus on differences between women and men. The comprehensive search was conducted in PUBMED, Medline, CINAHL and psychINFO in March 2023. The extracted publications were grouped and analyzed according to their objectives.

Results

A total of 264 papers were included in the analysis and divided into three categories: “physiological aspects of sexuality”, “psychological aspects of sexuality”, and “sexual adjustment”. Most assessments of sexuality after SCI/D concern physiological aspects (n = 176, 66.7%). Fewer studies focus on psychological aspects (n = 49, 18.6%), and sexual adjustment (n = 39, 14.8%) is the least investigated topic. More research has been published on men’s compared to women’s sexuality (n = 195, 73.9% versus n = 125, 47.3%). In men, the most frequently used standardized assessment is the International Index for Erectile Function (IIEF). In women, the equivalent to the IIEF, the Female Sexual Function Index (FSFI), is most frequently used.

Conclusion

Most assessments focus primarily on sexual function in men. New assessments are needed to address other aspects of sexuality as well. Furthermore, more research on female sexuality is needed.

Sexual function is the most commonly investigated aspect of sexuality in individuals with spinal cord injury or disease – a systematic review

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Fig. 1: PRISMA flow diagram showing the different stages of the systematic review process, from the identification of potential studies through to the final inclusion.

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Data availability

The generated and analyzed datasets are available from the corresponding author on reasonable request.

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Funding

Swiss Paraplegic Research.

Author information

Authors and Affiliations

  1. Swiss Paraplegic Research, Nottwil, Switzerland

    Jasmin L. Mahler, Judith J. W. van Beek, Jens Wöllner, Jörg Krebs & Jürgen Pannek

  2. Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland

    Jasmin L. Mahler

  3. Neuro-Urology, Swiss Paraplegic Centre, Nottwil, Switzerland

    Jens Wöllner & Jürgen Pannek

  4. Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

    Jürgen Pannek

Authors
  1. Jasmin L. Mahler
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  2. Judith J. W. van Beek
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  4. Jörg Krebs
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Contributions

JLM: study conception and design of systematic review, developed the review protocol, literature search, data extraction, and analysis. Wrote and revised the manuscript. Approval of final version. JJWvB: screening and extraction of data, critical editing of manuscript, approval of final version. JW: study conception, resolution of disagreements in screening process, critical editing of manuscript, approval of final version. JK: study conception and design, screening of data, supervision, assisted with interpretation of data, critical editing of manuscript, approval of final version. JP: study conception and design, supervision, assisted with interpretation of data, provided clinical expertise, critical editing of manuscript, approval of final version.

Corresponding author

Correspondence to Jörg Krebs.

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Attribution of work: Swiss Paraplegic Research, Nottwil, Switzerland.

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Mahler, J.L., van Beek, J.J.W., Wöllner, J. et al. Sexual function is the most commonly investigated aspect of sexuality in individuals with spinal cord injury or disease – a systematic review. Spinal Cord 63, 523–529 (2025). https://doi.org/10.1038/s41393-025-01111-y

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