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Vertebral Trauma and Sexuality -a survey research
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Abstract(s)
Introdução: A Lesão Vertebro-Medular (LVM) refere-se a danos na medula espinhal
que podem resultar na perda, temporária ou permanente, das funções motoras,
sensoriais e autonómicas, afetando significativamente a qualidade de vida. A saúde
sexual é uma das dimensões afetada pela LVM, não só pelo dano medular, como também
pelos fatores individuais que podem influenciar a perceção da atividade sexual como
satisfatória e gratificante. Para além das implicações individuais, a lesão provoca um
forte impacto na dinâmica relacional e conjugal, exigindo adaptações na relação.
Objetivos: O presente estudo pretende analisar e compreender as perceções e
experiências dos doentes com LVM sobre a sua sexualidade, abordando aspetos físicos e
psicológicos, bem como a dinâmica conjugal antes e após a lesão. Pretende-se ainda
identificar lacunas na abordagem clinica da saúde sexual em doentes com LVM.
Materiais e métodos: Trata-se de um estudo observacional, transversal e descritivo,
realizado no Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais. A
amostra incluiu 23 indivíduos do sexo masculino com idade = 18 anos, com diagnóstico
médico de LVM, atividade sexual prévia ao trauma e internamento ou acompanhamento
no CMRRC-RP. A recolha de dados foi feita através de um questionário estruturado,
desenvolvido em colaboração com o orientador, que inclui dados sociodemográficos,
informações clínicas e questões sobre sexualidade e relação conjugal. A análise estatística
foi realizada no SPSS, utilizando testes de Qui-Quadrado, Mann-Whitney e KruskallWallis, com significância estatística para p<0.05.
Resultados: A amostra foi composta exclusivamente por homens, com uma mediana
de idade de 48 anos. Antes da lesão, todos estavam empregados, mas após a LVM, 60.9%
ficaram inativos. A maioria dos participantes apresentava lesões acima de T11 (82.6%),
sendo que 69.6% reportaram sensibilidade genital preservada. A mediana do Quociente
Sexual Masculino (QSM) foi de 20, indicando elevados níveis de insatisfação sexual, com
30.4% dos participantes classificados como muito insatisfeitos. O controlo ejaculatório
foi afetado (mediana =1), indicando elevada prevalência de ejaculação prematura.
Apenas 47.8% tinham falado com um profissional de saúde, sendo que estes
apresentaram QSM significativamente mais elevados (p=0.014). Participantes com lesão
há mais de um ano apresentaram maior QSM (p=0.027) e satisfação com a vida
(p=0.002), sugerindo que o tempo desde a lesão pode influenciar a adaptação sexual.
Além disso, 45.5% dos indivíduos com menos de 45 anos demonstraram preocupação com a fertilidade (p=0.014). A relação conjugal sofreu alterações, com redução na
concordância de demonstrações de afeto e redução da frequência de discussões calmas.
Conclusão: Este estudo permitiu compreender o impacto significativo da LVM na
sexualidade e na qualidade de vida dos indivíduos afetados através da análise de diversas
dimensões, demonstrando que esta é complexa e influenciada por múltiplas variáveis,
incluindo fatores médicos, psicológicos e sociais. Os resultados sublinham a importância
de uma abordagem abrangente e individualizada no processo de reabilitação, bem como
a relevância de aspetos frequentemente negligenciados, como a fertilidade e as dinâmicas
conjugais. Novos estudos com amostras mais amplas são necessários para aprofundar
esta temática.
Introduction: Spinal Cord Injury (SCI) refers to damage to the spinal cord that can result in temporary or permanent loss of motor, sensory and autonomic functions, significantly affecting quality of life. Sexual health is one of the dimensions affected by SCI, not only due to the spinal cord damage, but also because of the individual factors that can influence the perception of sexual activity as satisfying and rewarding. In addition to the individual implications, the injury has a strong impact on relational and marital dynamics, requiring adaptations in the relationship. Objectives: This study aims to analyze and understand the perceptions and experiences of patients with SCI regarding their sexuality, and addressing physical and psychological aspects as well as relationship dynamics before and after the injury. It also aims to identify gaps in the clinical approach to sexual health in individuals with SCI. Materials and Methods: This was an observational, cross-sectional and descriptive study carried out at the Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais. The sample included 23 males aged 18 or older, with a medical diagnosis of SCI, previous sexual activity before the trauma, and either hospitalization or follow-up at the center. Data was collected using a structured questionnaire and developed in collaboration with the counsellor, which included sociodemographic data, clinical information and questions related to sexuality and relationships. Statistical analysis was carried out in SPSS, using Chi-Squared, Mann-Whitney and Kruskall-Wallis tests, with statistical significance for p<0.05. Results: The sample was made up exclusively of men, with a median age of 48. Before the injury, all were employed, but after SCI, 60.9% became inactive. Most participants had lesions above T11 (82.6%), and 69.6% reported preserved genital sensitivity. The median Male Sexual Quotient (QSM) was 20, indicating high levels of sexual dissatisfaction, with 30.4% of participants classified as very dissatisfied. Ejaculatory control was affected (median = 1), indicating a high prevalence of premature ejaculation. Only 47.8% had spoken to a healthcare professional about their sexual function, and those who did had significantly higher QSM (p=0.014). Participants who had been involved for more than a year had higher QSM (p=0.027) and satisfaction with life (p=0.002), suggesting that the time since the injury may influence sexual adaptation. In addition, 45.5% of individuals under 45 showed concerns about fertility (p=0.014) Marital relationships were affected, with a reduction in the agreement on displays of affection and a decrease in the frequency of calm discussions. Conclusions: This study made it possible to understand the significant impact of SCI on the sexuality and quality of life of affected individuals by analyzing various dimensions, demonstrating that sexuality is complex and influenced by multiple variables, including medical, psychological and social factors. The results underline the importance of a comprehensive and individualized approach in the rehabilitation process, as well as the relevance of often overlooked aspects such as fertility and marital dynamics. Further studies with larger samples are needed to explore this topic in greater depth.
Introduction: Spinal Cord Injury (SCI) refers to damage to the spinal cord that can result in temporary or permanent loss of motor, sensory and autonomic functions, significantly affecting quality of life. Sexual health is one of the dimensions affected by SCI, not only due to the spinal cord damage, but also because of the individual factors that can influence the perception of sexual activity as satisfying and rewarding. In addition to the individual implications, the injury has a strong impact on relational and marital dynamics, requiring adaptations in the relationship. Objectives: This study aims to analyze and understand the perceptions and experiences of patients with SCI regarding their sexuality, and addressing physical and psychological aspects as well as relationship dynamics before and after the injury. It also aims to identify gaps in the clinical approach to sexual health in individuals with SCI. Materials and Methods: This was an observational, cross-sectional and descriptive study carried out at the Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais. The sample included 23 males aged 18 or older, with a medical diagnosis of SCI, previous sexual activity before the trauma, and either hospitalization or follow-up at the center. Data was collected using a structured questionnaire and developed in collaboration with the counsellor, which included sociodemographic data, clinical information and questions related to sexuality and relationships. Statistical analysis was carried out in SPSS, using Chi-Squared, Mann-Whitney and Kruskall-Wallis tests, with statistical significance for p<0.05. Results: The sample was made up exclusively of men, with a median age of 48. Before the injury, all were employed, but after SCI, 60.9% became inactive. Most participants had lesions above T11 (82.6%), and 69.6% reported preserved genital sensitivity. The median Male Sexual Quotient (QSM) was 20, indicating high levels of sexual dissatisfaction, with 30.4% of participants classified as very dissatisfied. Ejaculatory control was affected (median = 1), indicating a high prevalence of premature ejaculation. Only 47.8% had spoken to a healthcare professional about their sexual function, and those who did had significantly higher QSM (p=0.014). Participants who had been involved for more than a year had higher QSM (p=0.027) and satisfaction with life (p=0.002), suggesting that the time since the injury may influence sexual adaptation. In addition, 45.5% of individuals under 45 showed concerns about fertility (p=0.014) Marital relationships were affected, with a reduction in the agreement on displays of affection and a decrease in the frequency of calm discussions. Conclusions: This study made it possible to understand the significant impact of SCI on the sexuality and quality of life of affected individuals by analyzing various dimensions, demonstrating that sexuality is complex and influenced by multiple variables, including medical, psychological and social factors. The results underline the importance of a comprehensive and individualized approach in the rehabilitation process, as well as the relevance of often overlooked aspects such as fertility and marital dynamics. Further studies with larger samples are needed to explore this topic in greater depth.
Description
Keywords
Lesão da Medula Espinal Saúde Sexual Sexualidade Trauma Vertebro-Medular