Skip to main content
SpringerLink
Log in

Sexual Rehabilitation for Men with Spinal Cord Injury: Preliminary Report on a Behavioral Strategy

  • Published:
Sexuality and Disability Aims and scope Submit manuscript

Abstract

Training of the perineal muscles was attempted in our centers on the basis of our previous findings indicating that when the appropriate source of stimulation is used, subjects exhibit peaks of activity suggesting a rehabilitation potential. Muscular training was considered because pressure stimulation of the glans penis triggers contractions of perineal muscles which propel the blood throughout the penis to ensure optimal tumescence. The technique was combined with biofeedback and home exercises and was tested on 10 patients initially presenting erectile difficulty but maintaining perineal innervation. The results showed significant improvements in average and maximal tumescence and maintenance of these improvements. The results are discussed in terms of their clinical application to a cognitive-behavioral approach to sexual dysfunction in spinal cord-injured men.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  1. Courtois FJ, Charvier KF, Leriche A, Raymond DP, Eyssette M: Clinical approach to erectile dysfunction in spinal cord injured men. A review of clinical and experimental data. Paraplegia 33:628–35, 1995.

    Google Scholar 

  2. Courtois FJ, Charvier KF, Leriche A, Raymond DP: Sexual function in spinal cord injury men. I Assessing sexual capability. Paraplegia 31:771–84, 1993.

    Google Scholar 

  3. Courtois FJ, Goulet MC, Charvier KF, Leriche A: Posttraumatic erectile potential of spinal cord injured men: how physiologic recordings supplement subjective reports. Archives of Physical Medicine and Rehabilitation 80:1268–1273, 1999.

    PubMed  Google Scholar 

  4. Karacan I, Aslan C, Hirshkowitz, M: Erectile mechanisms in man. Science 220:1080, 1983.

    PubMed  Google Scholar 

  5. Karacan I, Hirshkowitz M, Salis PJ, Narter E, Fayez Safi M: Penile blood flow and musculovascular events during sleep related erections of middle-aged men. Journal of Urology 138:177–81, 1987.

    PubMed  Google Scholar 

  6. Lavoisier P, Courtois F., Barres D, Blanchard M: Correlation between intracavernous pressure and contraction of the ischiocavernosus muscle in man. Journal of Urology 136:936–39, 1986.

    PubMed  Google Scholar 

  7. Lavoisier P, Proulx, J, Courtois F: Reflex contractions of the ischiocavernosus muscles following electrical and pressure stimulations. Journal of Urology 1139:396–99, 1988.

    Google Scholar 

  8. Wespes E, Nogueira MC, Hervaut AG, Cafriez M, Schulmann CC: Role of the bulbocavernosus muscles on the mechanism of human erection. European Urology 18:45–48, 1990.

    Google Scholar 

  9. Chapelle PA, Durand J, Lacert P: Penile erection following complete spinal cord injury in man. British Journal of Urology 52:216–19, 1980.

    PubMed  Google Scholar 

  10. Kennedy S, Over R: Psychophysiological assessment of male sexual arousal following spinal cord injury. Archives of Sexual Behavior 9:15–27, 1990.

    Google Scholar 

  11. Lamid S: Nocturnal penile tumescenc studies in spinal cord injured males. Paraplegia 26–31, 1985.

  12. Beckett SD, Hudson R, Walker DF, Reynolds TM, Vachon RI: Blood pressures and penile muscle activity in stallion during coitus. American Journal of Physiology 225:1072, 1973.

    PubMed  Google Scholar 

  13. Beckett SD, Walker DF, Hudson R, Reynolds TM, Vachon RI: Corpus cavernosum penis pressure and penile muscle activity in the bull during coitus. American Journal of Veterinary Research 35:761, 1974.

    PubMed  Google Scholar 

  14. Beckett SD, Purohit RC, Reynolds TM: The corpus spongiosum penis pressure and external penile muscle activity in the goat during coitus. Biology and Reproduction 12:289, 1975.

    Google Scholar 

  15. LoPiccolo J, LoPiccolo L: Handbook of Sex Therapy. New York, Plenum Press, 1978.

    Google Scholar 

  16. Kaplan H: The New Sex Therapy. New York: Brunner/Mazel, 1974.

    Google Scholar 

  17. Masters WH, Johnson VE: Human Sexual Inadequacy. Boston: Little, Brown and Company, 1970.

    Google Scholar 

  18. Boolell M, Gepi-Attee S, Gingel JC, Allen MF: Sildenafil, a novel effective oral therapy for male erectile dysfunction. British Journal of Urology 78:257–6, 1996.

    PubMed  Google Scholar 

  19. Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steer WD, Wicker PA: Oral sildenafil in the treatment of erectile dysfunction. New England Journal of Medicine 338:1397–404, 1998.

    PubMed  Google Scholar 

  20. Morales A, Gingell C, Collins M, Wickers PA Osterloh IH: Clinical safety of oral sildenafil citrate (Viagra) in the treatment of erectile dysfunction. International Journal of Impotence Research 10:69–74, 1998.

    PubMed  Google Scholar 

  21. Bors E, Comarr AE: Neurological disturbances of sexual function with special reference to 529 patients with spinal cord injury. Urological Survey 10:191–222, 1960.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute de Réadaptation de Montréal, Montréal, Québec, Canada, H3S 2J4

    Frédérique J. Courtois & Bernard Leduc

  2. Département de Sexologie, Université du Québec à Montréal, Montréal, Québec, Canada, H3C 3P8

    Catherine Mathieu & Marc Bélanger

  3. Hospices Civils de Lyon, 69565 Saint-Génis-Laval, France

    Kathleen F. Charvier

Authors
  1. Frédérique J. Courtois
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Catherine Mathieu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kathleen F. Charvier
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bernard Leduc
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marc Bélanger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Frédérique J. Courtois.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Courtois, F.J., Mathieu, C., Charvier, K.F. et al. Sexual Rehabilitation for Men with Spinal Cord Injury: Preliminary Report on a Behavioral Strategy. Sexuality and Disability 19, 149–157 (2001). https://doi.org/10.1023/A:1010629907408

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1010629907408

Search

Navigation