Sexual functioning is a high priority for people with a spinal cord injury (SCI) yet this area has received little attention. Two SCI case reports are presented which suggests there may be greater potential for the recovery of sexual functioning than previously recognised.
A 74-year-old SCI male (AIS D, C5/C6) and a 36-year-old SCI male (AIS A, T4/T5) were treated for neurogenic bowel using 6 weeks of abdominal FES (ABFES) (40 Hz, 300 µ pulse width (current typically 30–60 MA) simultaneously delivered (8 s contraction with 2 s ramps and 3 s off period) from both channels). The 74-year-old AIS D, C5/C6 participant reported improved strength and duration of erectile function after using ABFES for 3 weeks. The 36-year-old AIS A, T4/T5 participant reported improvements in ejaculatory function and urine flow. Both reported a reduction in time required for bowel management.
The findings could be attributed to an improved vascularisation of the abdominal area, an improved body image and self-esteem, direct innervation of nerves involved in parasympathetic pathways or innervation of the T11/T1 area implicated in the alternative psychogenic pathway. Both participants reported they had not used ABFES during sexual activity suggesting a therapeutic effect from the treatment.
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The authors acknowledge the contribution of Joe Green, Mary Fenn and Earl Merson from the National Clinical FES Centre, Salisbury, UK for administering the ABFES treatment for one of the participants. With thanks to Odstock Medical for providing the use of an electrical stimulator and consumables for treatment of one of the participants. All other treatment was funded by the UK National Health Service.
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Street, T., Padfield, E. A therapeutic effect for males with spinal cord injury using abdominal functional electrical stimulation for sexual functioning. Spinal Cord Ser Cases 6, 24 (2020). https://doi.org/10.1038/s41394-020-0273-x