Effects of intrathecal baclofen on perceived sexual functioning in men with spinal cord injury.
OBJECTIVE
Reports in the literature suggest that administration of intrathecal baclofen to control spasticity may have deleterious effects on erectile function in men with spinal cord injury (SCI). A prospective study was conducted to document any changes in perceived sexual function after implant of a baclofen pump.


METHODS
Seven adult men with SCI (ASIA A or B) who received intrathecal baclofen through an implantable pump for treatment of severe spasticity were followed for an average of 670 days (22.4 months) after implant. Perceived sexual function was assessed using the Brief Sexual Function Inventory. Severity of spasticity and overall health-related quality of life were also assessed.


RESULTS
Participants reported improvements in spasticity severity and overall health-related quality of life. Two of 7 participants reported some negative changes in perceived sexual function after baclofen pump implant, noted in the areas of reduced sex drive and problems with erections (frequency, rigidity, difficulty in achieving). However, most participants reported minimal effects on sexual function, and 2 participants reported marked improvement in perceived sexual function from pre- to post-implant. Analysis of changes in perceived sexual function over time suggest that problems may be associated with an increase in baclofen dose and may be reversible with a reduction in dose.


CONCLUSIONS
Intrathecal baclofen may impact perceived sexual function particularly at higher doses. However, the effects seem to be reversible with withdrawal or reduction of baclofen administration.
Crawford Research Institute, Shepherd Center, 2020 Peachtree Rd, NW, Atlanta, GA 30309, USA. mike_jones@shepherd.org
Michael L
ML
Jones
Donald P
DP
Leslie
Gerald
G
Bilsky
Brock
B
Bowman
D000328:Adult; D001418:Baclofen / Q000009:adverse effects*; D007172:Erectile Dysfunction / Q000139:chemically induced* / Q000523:psychology*; D006306:Health Surveys; D006801:Humans; D015918:Infusion Pumps, Implantable; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000009:adverse effects*; D009128:Muscle Spasticity / Q000188:drug therapy / Q000209:etiology*; D011788:Quality of Life; D013119:Spinal Cord Injuries / Q000150:complications*; D013997:Time Factors
D009125:Muscle Relaxants, Central; D001418:Baclofen