title: Long-term effects of spinal cord injury on sexual function in men: implications for neuroplasticity.
abstract: METHODS
  Secure, web-based survey.
  
  
  OBJECTIVE
  Elicit specific information about sexual function from men with spinal cord injuries (SCI).
  
  
  METHODS
  World-wide web.
  
  
  METHODS
  Individuals 18 years or older living with SCI obtained a pass-code to enter a secure website and then answered survey questions.
  
  
  RESULTS
  The presence of genital sensation was positively correlated with the ability to feel a build up of sexual tension in the body during sexual stimulation and in the feeling that mental arousal translates to the genitals as physical sensation. There was an inverse relationship between developing new areas of arousal above the level of lesion and not having sensation or movement below the lesion. A positive relationship existed between the occurrence of spasticity during sexual activity and erectile ability. Roughly 60% of the subjects had tried some type of erection enhancing method. Only 48% had successfully achieved ejaculation postinjury and the most commonly used methods were hand stimulation, sexual intercourse, and vibrostimulation. The most commonly cited reasons for trying to ejaculate were for pleasure and for sexual intimacy. Less than half reported having experienced orgasm postinjury and this was influenced by the length of time postinjury and sacral sparing.
  
  
  CONCLUSIONS
  SCI not only impairs male erectile function and ejaculatory ability, but also alters sexual arousal in a manner suggestive of neuroplasticity. More research needs to be pursued in a manner encompassing all aspects of sexual function.
authors.affiliation: Department of Neurological Surgery, Reeve-Irvine Research Center, University of California, Irvine, CA 92697, USA.
authors.forename: K D
authors.initials: KD
authors.lastname: Anderson
authors.forename: J F
authors.initials: JF
authors.lastname: Borisoff
authors.forename: R D
authors.initials: RD
authors.lastname: Johnson
authors.forename: S A
authors.initials: SA
authors.lastname: Stiens
authors.forename: S L
authors.initials: SL
authors.lastname: Elliott
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology; D000328:Adult; D004542:Ejaculation / Q000502:physiology; D005260:Female; D005298:Fertility / Q000502:physiology; D006801:Humans; D008297:Male; D009473:Neuronal Plasticity / Q000502:physiology*; D009948:Orgasm / Q000502:physiology; D010410:Penile Erection / Q000502:physiology; D010413:Penis / Q000294:innervation / Q000502:physiology; D012677:Sensation / Q000502:physiology; D012725:Sexual Behavior / Q000502:physiology*; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000523:psychology*; D011795:Surveys and Questionnaires