title: Discussing sexual health in spinal care.
abstract: BACKGROUND
  The possible detrimental effects of spinal disease on sexual health are widely recognized; however, it is not known to what extent neurosurgeons discuss this topic with their patients. The aim of this study is to identify knowledge, attitude and practice patterns of neurosurgeons counseling their patients about sexual health.
  
  
  METHODS
  All members of the Dutch Association of Neurosurgery (neurosurgeons and residents) were sent a questionnaire addressing their attitudes, knowledge and practice patterns regarding discussing sexual health.
  
  
  RESULTS
  Response rate was 62% with 89 questionnaires suitable for analysis. The majority of participants (83%) were male; mean age, 42.4 years. The mean experience in neurosurgical practice was 9 years. Respondents assumed that in 34% of their patients, sexual health was affected due to spinal disease. The majority of respondents (64%) stated that responsibility for discussing sexual health lies (partly) with the neurosurgeon; however, 73% indicated to (almost) never do this. The main reasons for not discussing sexual health were patients' old age (42%), lack of knowledge (38%) and lack of patients' initiative to bring up the subject (36%). Twenty-six percent indicated lack of time as a reason. There was no evidence for gender or doctor's age discordance as important barriers. Fifty percent of participants wished to gain more knowledge on discussing sexual health with patients.
  
  
  CONCLUSIONS
  This study shows that despite high prevalence of sexual dysfunction (SD) in spinal patients, counseling about sexual health is not often done in neurosurgical care. More training on sexual health counseling early in the residency program seems critical. By initiating the discussion, clinicians who deal with spinal patients have the potential to detect sexual dysfunction (SD) and to refer adequately when necessary, thereby improving overall quality of life of their patients.
authors.affiliation: Department of Neurosurgery, Leiden University Medical Center, Postzone J11-R-83, Postbus 9600, 2300 RC, Leiden, The Netherlands. n.s.korse@lumc.nl.
authors.forename: N S
authors.initials: NS
authors.lastname: Korse
authors.affiliation: Department of Urology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: M P J
authors.initials: MP
authors.lastname: Nicolai
authors.affiliation: Department of Psychosomatic Gynecology and Sexology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Both
authors.affiliation: Department of Neurosurgery, Leiden University Medical Center, Postzone J11-R-83, Postbus 9600, 2300 RC, Leiden, The Netherlands.
authors.forename: C L A
authors.initials: CL
authors.lastname: Vleggeert-Lankamp
authors.affiliation: Department of Urology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: H W
authors.initials: HW
authors.lastname: Elzevier
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003376:Counseling; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010353:Patient Education as Topic / Q000379:methods / Q000592:standards*; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology; D012017:Referral and Consultation / Q000706:statistics & numerical data; D060728:Reproductive Health; D012735:Sexual Dysfunction, Physiological / Q000209:etiology* / Q000534:rehabilitation; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology* / Q000534:rehabilitation; D013119:Spinal Cord Injuries / Q000150:complications* / Q000534:rehabilitation; D055815:Young Adult
keywords: Cauda equina syndrome; Counseling; Patient care; Sexual dysfunction; Spinal cord injury