title: Sexual Functioning in Men Living with a Spinal Cord Injury-A Narrative Literature Review.
abstract: BACKGROUND
  Sexual dysfunction is a major concern for Indian men living with a spinal cord injury.
  
  
  OBJECTIVE
  To examine the literature related to sexuality traumatic cord injury and its impact on sexual functioning.
  
  
  METHODS
  Databases using Cumulative Index to Nursing and Allied Health Literature (CINAHL) 2000-2012, Medline 1989-2012, Applied Social Sciences Index and Abstracts (ASSIA) 1989-2012 and Google Scholar were the search engines used used for literature review.
  
  
  RESULTS
  The search yielded a total of 457 articles and only 75 of them were found relevant. The minimum number of articles required to meet the inclusion criteria for this review was 25-30 articles. Out of the 75 articles, 33 were considered relevant or related to the topic of sexual functioning, spinal cord injury, and paraplegia. Six areas were identified: Sexual stigmatization, physiological barriers to sexual satisfaction, clinical aspects of sexual functioning, biomedical approaches to sexual dysfunction, partner satisfaction, and lack of accessibility to sexual education.
  
  
  CONCLUSIONS
  Spinal cord injury and sexual functioning affects a large segment of the male Indian population, yet most current research focuses on quantitative measurement with the emphasis on ejaculatory dysfunction, orgasm impairment, incontinence, and other physiological dysfunction. Further research is needed to address the subjective accounts of patients themselves with respect to the emotional and social impact of sexual disability. This would help to identify the best possible outcomes for both treatment and rehabilitation.
authors.affiliation: Department of Research and Training, Trivandrum Institute of Palliative Sciences, Trivandrum, Kerala, India.
authors.forename: M M
authors.initials: MM
authors.lastname: Sunilkumar
authors.affiliation: Department of Family Practice, Faculty of Medicine, University of British Columbia, University Boulevard, Vancouver, British Columbia, Canada.
authors.forename: Patricia
authors.initials: P
authors.lastname: Boston
authors.affiliation: Department of Research and Training, Trivandrum Institute of Palliative Sciences, Trivandrum, Kerala, India.
authors.forename: M R
authors.initials: MR
authors.lastname: Rajagopal
keywords: Indian men; Qualitative research; Sexual dysfunction; Sexual stigmatization; Sexuality; Spinal cord injury