Sexual Rehabilitation in Spinal Cord Injury
Summary
Spinal cord injury (SCI) disrupts neural pathways that support sexual function, leading to challenges in desire, arousal, erection, ejaculation and satisfaction. These changes affect both men and women, with implications for fertility, self-esteem and intimate relationships. Sexual rehabilitation aims to address physiological, psychological and social dimensions through a combination of pharmacotherapy, assistive devices, neuromodulation, counselling and partner education. Its goals are to restore or adapt sexual activity, enhance quality of life and promote social participation. A multidisciplinary team—including rehabilitation physicians, urologists, physiotherapists, psychologists and sexual health specialists—must tailor interventions to individual needs and injury levels. Technological advances such as vibratory stimulators and neuromodulation devices have expanded options for inducing erection and ejaculation. Concurrently, psychoeducational and couples-based therapies tackle body image concerns, interpersonal communication and relationship dynamics. A rights-based approach that integrates sexual health into routine rehabilitation pathways is essential to address global disparities and ensure holistic recovery for people living with SCI.
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Sexual Rehabilitation in Spinal Cord Injury publication trend
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Technical terms
Spinal cord injury (SCI): Damage to the spinal cord that results in loss of sensory and motor functions below the level of the lesion.
Anejaculation: Absence of voluntary or reflexive ejaculation despite adequate sexual stimulation.
Erectile dysfunction (ED): Inability to attain or maintain an erection sufficient for satisfactory sexual performance.
Penile vibratory stimulation (PVS): Application of high-frequency mechanical vibration to the penis to trigger ejaculation via intact reflex pathways.
Pelvic muscle vibration: Targeted vibration applied to pelvic floor muscles to reduce spasticity and enhance sexual function.
Spasticity: Increased muscle tone and involuntary contractions resulting from disrupted neural inhibition after injury.
Psychosocial: Pertaining to the interaction of psychological factors and the social environment in influencing behaviour and well-being.
References
- Views and Experiences of Sex, Sexuality and Relationships Following Spinal Cord Injury: A Systematic Review and Narrative Synthesis of the Qualitative Literature. Sexuality and Disability (2020).
- Examining the psychological and emotional experience of sexuality for men after spinal cord injury. Cogent Psychology (2020).
- Improving Sexual Function by Using Focal Vibrations in Men with Spinal Cord Injury: Encouraging Findings from a Feasibility Study. Journal of Clinical Medicine (2019).
- Enhancing Psychological Sexual Health of People With Spinal Cord Injury and Their Partners in an Italian Unipolar Spinal Unit: A Pilot Data Study. Frontiers in Psychology (2019).
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