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How to use this Website?

This website is for medical and paramedical professionals working in the field of spinal cord injuries. It contains learning modules for the whole team as well as for doctors, nurses, physiotherapists, occupational therapists, assistive technologists, social workers, psychologists and peer counsellors. The modules are intended for medical and paramedical students and junior clinicians. Others who have yet not assimilated sufficient knowledge on comprehensive management.

Sexuality, Fertility & SCI

  1. Sexuality and reproductive health in adults with spinal cord injury: a clinical practice guideline for health-care professionals. The journal of spinal cord medicine 2010; 33: 281-336.
    The guideline can be downloaded from:
    https://pva.org/wp-content/uploads/2021/09/cpg_sexuality-and-reproductive-health.pdf
  2. Elliott S, Querée M (2018). Sexual and Reproductive Health Following Spinal Cord Injury. In Eng JJ, Teasell RW, Miller WC, Wolfe DL, Townson AF, Hsieh JTC, Connolly SJ, Noonan VK, Loh E, Sproule S, McIntyre A, Querée M editors. Spinal Cord Injury Rehabilitation Evidence. Version 6.0. Vancouver: p 1- 133
    The review can be downloaded from:
    https://scireproject.com/wp-content/uploads/SCIRE-Sexual-Health-Version-6-chapter_Nov.23.18-v.FINAL-1.pdf
  3. Alexander MS, Biering-Sørensen F, Elliott S, Kreuter M, Sønksen J. International spinal cord injury female sexual and reproductive function basic data set. Spinal cord 2011; 49: 787-790.
  4. Alexander MS, Biering-Sørensen F, Elliott S, Kreuter M, Sønksen J. International spinal cord injury male sexual function basic data set. Spinal cord 2011; 49: 795-798.
  5. Alexander MS, Rosen RC, Steinberg S, Symonds T, Haughie S, Hultling C. Sildenafil in women with sexual arousal disorder following spinal cord injury. Spinal cord 2011; 49: 273-279.
  6. Anderson KD, Borisoff JF, Johnson RD, Stiens SA, Elliott SL. Spinal cord injury influences psychogenic as well as physical components of female sexual ability. Spinal cord 2007; 45: 349-359.
  7. Arafa MM, Zohdy WA, Shamloul R. Prostatic massage: a simple method of semen retrieval in men with spinal cord injury. International journal of andrology 2007; 30: 170-173.
  8. Axel SJ. Spinal cord injured women's concerns: menstruation and pregnancy. Rehabilitation nursing: the official journal of the Association of Rehabilitation Nurses 1982; 7: 10-15.
  9. Baastrup C, Finnerup NB. Pharmacological management of neuropathic pain following spinal cord injury. CNS drugs 2008; 22: 455-475.
  10. Bennett CJ, Seager SW, Vasher EA, McGuire EJ. Sexual dysfunction and electroejaculation in men with spinal cord injury: review. The Journal of urology 1988; 139: 453-457.
  11. Biering-Sørensen F, Kennelly M, Kessler TM, Linsenmeyer T, Pannek J, Vogel L, Wyndaele JJ. International Spinal Cord Injury Lower Urinary Tract Function Basic Data Set (version 2.0). Spinal Cord Ser Cases. 2018 Jul 6; 4: 60.
  12. Biering-Sørensen F, Sønksen J. Penile erection in men with spinal cord or cauda equina lesions. Seminars in neurology 1992; 12: 98-105.
  13. Black K, Sipski ML, Strauss SS. Sexual satisfaction and sexual drive in spinal cord injured women. The journal of spinal cord medicine 1998; 21: 240-244.
  14. Brackett NL. Penile vibratory stimulation for men with spinal cord injury. Human reproduction update 1999; 5: 551-552.
  15. Brackett NL, Ead DN, Aballa TC, Ferrell SM, Lynne CM. Semen retrieval in men with spinal cord injury is improved by interrupting current delivery during electroejaculation. The Journal of urology 2002; 167: 201-203.
  16. Brackett NL, Ferrell SM, Aballa TC, Amador MJ, Padron OF, Sonksen J et al. An analysis of 653 trials of penile vibratory stimulation in men with spinal cord injury. The Journal of urology 1998; 159: 1931-1934.
  17. Brackett NL, Kafetsoulis A, Ibrahim E, Aballa TC, Lynne CM. Application of 2 vibrators salvages ejaculatory failures to 1 vibrator during penile vibratory stimulation in men with spinal cord injuries. The Journal of urology 2007; 177: 660-663.
  18. Brackett NL, Lynne CM, Ibrahim E, Ohl DA, Sønksen J. Treatment of infertility in men with spinal cord injury. Nature reviews. Urology 2010; 7: 162-172.
  19. Brackett NL, Ibrahim E, Iremashvili V, Aballa TC, Lynne CM. Treatment for ejaculatory dysfunction in men with spinal cord injury: an 18-year single center experience. J Urol. 2010 Jun;183(6):2304-8. doi: 10.1016/j.juro.2010.02.018.
  20. Brindley GS. The fertility of men with spinal injuries. Paraplegia 1984; 22: 337-348.
  21. Bughi S, Shaw SJ, Mahmood G, Atkins RH, Szlachcic Y. Amenorrhea, pregnancy, and pregnancy outcomes in women following spinal cord injury: a retrospective cross-sectional study. Endocrine practice: official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists 2008; 14: 437-441.
  22. Burns AS, Jackson AB. Gynecologic and reproductive issues in women with spinal cord injury. Physical medicine and rehabilitation clinics of North America 2001; 12: 183-199.
  23. Charlifue SW, Gerhart KA, Menter RR, Whiteneck GG, Manley MS. Sexual issues of women with spinal cord injuries. Paraplegia 1992; 30: 192-199.
  24. Claydon VE, Elliott SL, Sheel AW, Krassioukov A. Cardiovascular responses to vibrostimulation for sperm retrieval in men with spinal cord injury. The journal of spinal cord medicine 2006; 29: 207-216.
  25. Deforge D, Blackmer J, Garritty C, Yazdi F, Cronin V, Barrowman N et al. Male erectile dysfunction following spinal cord injury: a systematic review. Spinal cord 2006; 44: 465-473.
  26. Del Popolo G, Li Marzi V, Mondaini N, Lombardi G. Time/duration effectiveness of sildenafil versus tadalafil in the treatment of erectile dysfunction in male spinal cord-injured patients. Spinal cord 2004; 42: 643-648.
  27. Derry F, Hultling C, Seftel AD, Sipski ML. Efficacy and safety of sildenafil citrate (Viagra) in men with erectile dysfunction and spinal cord injury: a review. Urology 2002; 60: 49-57.
  28. Earle CM, Keogh EJ, Ker JK, Cherry DJ, Tulloch AG, Lord DJ. The role of intracavernosal vasoactive agents to overcome impotence due to spinal cord injury. Paraplegia 1992; 30: 273-276.
  29. Elliott S, Hocaloski S, Carlson M. A Multidisciplinary Approach to Sexual and Fertility Rehabilitation: The Sexual Rehabilitation Framework. Top Spinal Cord Inj Rehabil. Winter 2017;23(1):49-56. doi: 10.1310/sci2301-49.
  30. Ekland M, Lawrie B. How a woman's sexual adjustment after sustaining a spinal cord injury impacts sexual health interventions. SCI nursing: a publication of the American Association of Spinal Cord Injury Nurses 2004; 21: 14-19.
  31. Ethans KD, Casey AR, Schryvers OI, MacNeil BJ. The effects of sildenafil on the cardiovascular response in men with spinal cord injury at or above the sixth thoracic level. The journal of spinal cord medicine 2003; 26: 222-226.
  32. Fode M, Ohl DA, Sønksen J. A step-wise approach to sperm retrieval in men with neurogenic anejaculation. Nat Rev Urol, 2015. 12(11): p. 607-16.
  33. Ferreiro-Velasco ME, Barca-Buyo A, de la Barrera SS, Montoto-Marqués A, Vázquez XM, Rodríguez-Sotillo A. Sexual issues in a sample of women with spinal cord injury. Spinal cord 2005; 43: 51-55.
  34. Forsythe E, Horsewell JE. Sexual rehabilitation of women with a spinal cord injury. Spinal cord 2006; 44: 234-241.
  35. García-Bravo AM, Suárez-Hernández D, Ruiz-Fernández MA, Silva González O, Bárbara-Bataller E, Méndez Suárez JL. Determination of changes in blood pressure during administration of sildenafil (Viagra) in patients with spinal cord injury and erectile dysfunction. Spinal cord 2006; 44: 301-308.
  36. Giuliano F, Hultling C, El Masry WS, Smith MD, Osterloh IH, Orr M et al. Randomized trial of sildenafil for the treatment of erectile dysfunction in spinal cord injury. Sildenafil Study Group. Annals of neurology 1999; 46: 15-21.
  37. Giuliano F, Rubio-Aurioles E, Kennelly M, Montorsi F, Kim ED, Finkbeiner AE et al. Vardenafil improves ejaculation success rates and self-confidence in men with erectile dysfunction due to spinal cord injury. Spine 2008; 33: 709-715.
  38. Giuliano F, Rubio-Aurioles E, Kennelly M, Montorsi F, Kim ED, Finkbeiner AE et al. Efficacy and safety of vardenafil in men with erectile dysfunction caused by spinal cord injury. Neurology 2006; 66: 210-216.
  39. Giuliano F, Sanchez-Ramos A, Löchner-Ernst D, Del Popolo G, Cruz N, Leriche A et al. Efficacy and safety of tadalafil in men with erectile dysfunction following spinal cord injury. Archives of neurology 2007; 64: 1584-1592.
  40. Giulini S, Pesce F, Madgar I, Marsella T, Volpe A, de Aloysio D et al. Influence of multiple transrectal electroejaculations on semen parameters and intracytoplasmic sperm injection outcome. Fertility and sterility 2004; 82: 200-204.
  41. Halstead LS, VerVoort S, Seager SW. Rectal probe electrostimulation in the treatment of anejaculatory spinal cord injured men. Paraplegia 1987; 25: 120-129.
  42. Hammell KW, Miller WC, Forwell SJ, Forman BE, Jacobsen BA. Fatigue and spinal cord injury: a qualitative analysis. Spinal cord 2009; 47: 44-49.
  43. Hirsch IH, Smith RL, Chancellor MB, Bagley DH, Carsello J, Staas WE, Jr. Use of intracavernous injection of prostaglandin E1 for neuropathic erectile dysfunction. Paraplegia 1994; 32: 661-664.
  44. Hultling C, Giuliano F, Quirk F, Peña B, Mishra A, Smith MD. Quality of life in patients with spinal cord injury receiving Viagra (sildenafil citrate) for the treatment of erectile dysfunction. Spinal cord 2000; 38: 363-370.
  45. Ibrahim E, Brackett NL, Lynne CM. Advances in the management of infertility in men with spinal cord injury. Asian J Androl. 2016 May-Jun; 18(3): 382–390. doi: 10.4103/1008-682X.178851.
  46. Jackson AB, Wadley V. A multicenter study of women's self-reported reproductive health after spinal cord injury. Archives of physical medicine and rehabilitation 1999; 80: 1420-1428.
  47. Khorrami MH, Javid A, Moshtaghi D, Nourimahdavi K, Mortazavi A, Zia HR. Sildenafil efficacy in erectile dysfunction secondary to spinal cord injury depends on the level of cord injuries. International journal of andrology 2010; 33: 861-864.
  48. Kolettis PN, Lambert MC, Hammond KR, Kretzer PA, Steinkampf MP, Lloyd LK. Fertility outcomes after electroejaculation in men with spinal cord injury. Fertility and sterility 2002; 78: 429-431.
  49. Kreuter M, Siösteen A, Biering-Sørensen F. Sexuality and sexual life in women with spinal cord injury: a controlled study. Journal of rehabilitation medicine: official journal of the UEMS European Board of Physical and Rehabilitation Medicine 2008; 40: 61-69.
  50. Krogh K, Emmanuel A, Perrouin-Verbe B, Korsten MA, Mulcahey MJ, Biering-Sørensen F. International spinal cord injury bowel function basic data set (Version 2.0). Spinal Cord. 2017; 55: 692-698.
  51. Krogh K, Halvorsen A, Pettersen AN, Biering-Sørensen F. Version 2.1 of the International Spinal Cord Injury Bowel Function Basic Data Set. Spinal Cord Ser Cases. 2019; 5: 63.
  52. Le Chapelain L, Nguyen Van Tam P, Dehail P, Berjon JJ, Barat M, Mazaux JM et al. Ejaculatory stimulation, quality of semen and reproductive aspects in spinal cord injured men. Spinal cord 1998; 36: 132-136.
  53. Linsenmeyer TA, Perkash I. Infertility in men with spinal cord injury. Archives of physical medicine and rehabilitation 1991; 72: 747-754.
  54. Linsenmeyer TA, Perkash I. Infertility in men with spinal cord injury. Archives of physical medicine and rehabilitation 1991; 72: 747-754.
  55. Lloyd LK, Richards JS. Intracavernous pharmacotherapy for management of erectile dysfunction in spinal cord injury. Paraplegia 1989; 27: 457-464.
  56. Löchner-Ernst D, Mandalka B, Kramer G, Stöhrer M. Conservative and surgical semen retrieval in patients with spinal cord injury. Spinal cord 1997; 35: 463-468.
  57. Lombardi G, Macchiarella A, Cecconi F, Del Popolo G. Ten-year follow-up of sildenafil use in spinal cord-injured patients with erectile dysfunction. The journal of sexual medicine 2009; 6: 3449-3457.
  58. Maytom MC, Derry FA, Dinsmore WW, Glass CA, Smith MD, Orr M et al. A two-part pilot study of sildenafil (VIAGRA) in men with erectile dysfunction caused by spinal cord injury. Spinal cord 1999; 37: 110-116.
  59. Ohl DA, Menge AC, Sønksen J. Penile vibratory stimulation in spinal cord injured men: optimized vibration parameters and prognostic factors. Archives of physical medicine and rehabilitation 1996; 77: 903-905.
  60. Ohl DA, Sønksen J, Menge AC, McCabe M, Keller LM. Electroejaculation versus vibratory stimulation in spinal cord injured men: sperm quality and patient preference. The Journal of urology 1997; 157: 2147-2149.
  61. Ohl DA, Wolf LJ, Menge AC, Christman GM, Hurd WW, Ansbacher R et al. Electroejaculation and assisted reproductive technologies in the treatment of anejaculatory infertility. Fertility and sterility 2001; 76: 1249-1255.
  62. Previnaire JG, Soler JM, Alexander MS, Courtois F, Elliott S, McLain A. Prediction of sexual function following spinal cord injury: a case series. Spinal Cord Ser Cases 2017; 3, 17096.
  63. Rupp R, Biering-Sørensen F, Burns SP, Graves DE, Guest J, Jones L, Read MS, Rodriguez GM, Schuld C, Tansey-Md KE, Walden K, Kirshblum S. International Standards for Neurological Classification of Spinal Cord Injury: Revised 2019. Top Spinal Cord Inj Rehabil. 2021 Spring;27(2):1-22.
  64. Rutberg L, Fridén B, Karlsson AK. Amenorrhoea in newly spinal cord injured women: an effect of hyperprolactinaemia? Spinal cord 2008; 46: 189-191.
  65. Sánchez Ramos A, Vidal J, Jáuregui ML, Barrera M, Recio C, Giner M et al. Efficacy, safety and predictive factors of therapeutic success with sildenafil for erectile dysfunction in patients with different spinal cord injuries. Spinal cord 2001; 39: 637-643.
  66. Schatte EC, Orejuela FJ, Lipshultz LI, Kim ED, Lamb DJ. Treatment of infertility due to anejaculation in the male with electroejaculation and intracytoplasmic sperm injection. The Journal of urology 2000; 163: 1717-1720.
  67. Sheel AW, Krassioukov AV, Inglis JT, Elliott SL. Autonomic dysreflexia during sperm retrieval in spinal cord injury: influence of lesion level and sildenafil citrate. Journal of applied physiology (Bethesda, Md.: 1985) 2005; 99: 53-58.
  68. Shieh J-Y, Chen S-U, Wang Y-H, Chang H-C, Ho H-N, Yang Y-S. A protocol of electroejaculation and systematic assisted reproductive technology achieved high efficiency and efficacy for pregnancy for anejaculatory men with spinal cord injury. Archives of physical medicine and rehabilitation 2003; 84: 535-540.
  69. Sidi AA, Cameron JS, Dykstra DD, Reinberg Y, Lange PH. Vasoactive intracavernous pharmacotherapy for the treatment of erectile impotence in men with spinal cord injury. The Journal of urology 1987; 138: 539-542.
  70. Sinha V, Elliott S, Ibrahim E, Lynne CM, Brackett NL Reproductive Health of Men with Spinal Cord Injury. Top Spinal Cord Inj Rehabil. 2017 Winter; 23(1):31-41. doi: 10.1310/sci2301-31.
  71. Sipski M, Alexander C, Gómez-Marín O, Spalding J. The effects of spinal cord injury on psychogenic sexual arousal in males. The Journal of urology 2007; 177: 247-251.
  72. Sipski M, Alexander CJ, Gómez-Marín O. Effects of level and degree of spinal cord injury on male orgasm. Spinal cord 2006; 44: 798-804.
  73. Sipski ML, Alexander CJ, Gomez-Marin O, Grossbard M, Rosen R. Effects of vibratory stimulation on sexual response in women with spinal cord injury. Journal of rehabilitation research and development 2005; 42: 609-616.
  74. Sipski ML, Alexander CJ, Rosen R. Sexual arousal and orgasm in women: effects of spinal cord injury. Annals of neurology 2001; 49: 35-44.
  75. Sipski ML, Alexander CJ, Rosen RC. Physiologic parameters associated with sexual arousal in women with incomplete spinal cord injuries. Archives of physical medicine and rehabilitation 1997; 78: 305-313.
  76. Sipski ML, Rosen RC, Alexander CJ, Hamer RM. Sildenafil effects on sexual and cardiovascular responses in women with spinal cord injury. Urology 2000; 55: 812-815.
  77. Soler JM, Previnaire JG, Denys P, Chartier-Kastler E. Phosphodiesterase inhibitors in the treatment of erectile dysfunction in spinal cord-injured men. Spinal cord 2007; 45: 169-173.
  78. Soler JM, Navaux MA, Previnaire JG. Positive sexuality in men with spinal cord injury. Spinal Cord 2018; 56: 1199-1206.
  79. Sønksen J, Biering-Sørensen F. Fertility in men with spinal cord or cauda equina lesions. Seminars in neurology 1992; 12: 106-114.
  80. Sønksen J, Biering-Sørensen F, Kristensen JK. Ejaculation induced by penile vibratory stimulation in men with spinal cord injuries. The importance of the vibratory amplitude. Paraplegia 1994; 32: 651-660.
  81. Sønksen J, Sommer P, Biering-Sørensen F, Ziebe S, Lindhard A, Loft A et al. Pregnancy after assisted ejaculation procedures in men with spinal cord injury. Archives of physical medicine and rehabilitation 1997; 78: 1059-1061.
  82. Taylor Z, Molloy D, Hill V, Harrison K. Contribution of the assisted reproductive technologies to fertility in males suffering spinal cord injury. The Australian & New Zealand journal of obstetrics & gynaecology 1999; 39: 84-87.
  83. Ullrich PM, Jensen MP, Loeser JD, Cardenas DD. Pain intensity, pain interference and characteristics of spinal cord injury. Spinal cord 2008; 46: 451-455.
  84. Watanabe T, Chancellor MB, Rivas DA, Hirsch IH, Bennett CJ, Finocchiaro MV et al. Epidemiology of current treatment for sexual dysfunction in spinal cord injured men in the USA model spinal cord injury centers. The journal of spinal cord medicine 1996; 19: 186-189.
  85. Wecht JM, Krassioukov AV, Alexander M, Handrakis JP, McKenna SL, Kennelly M, Trbovich M, Biering-Sorensen F, Burns S, Elliott SL, Graves D, Hamer J, Krogh K, Linsenmeyer TA, Liu N, Hagen EM, Phillips AA, Previnaire JG, Rodriguez GM, Slocum C, Wilson JR. International Standards to document Autonomic Function following SCI (ISAFSCI): Second Edition. Top Spinal Cord Inj Rehabil. 2021 Spring; 27(2): 23-49.
  86. Zaslau S, Nicolis C, Galea G, Britanico J, Vapnek JM. A simplified pharmacologic erection program for patients with spinal cord injury. The journal of spinal cord medicine 1999; 22: 303-307.