Sexual Health Table 13: Effects of Interventions to improve Orgasm

Author Year; Country

Score

Research Design

Total Sample Size

Methods

Outcome

Overgoor et al. 2013;

The Netherlands

Pre-post

N=30

Population: 30 men (SCI n=12, Spina bifida n=18) with no penile sensation but good groin sensation.

Treatment: TOMAX (TO MAX-imize sensation, sexuality and quality of life) procedure that involved microsurgical connection of the sensory ilioinguinal nerve to the dorsal nerve of the penis unilaterally.

Outcome measures: Sensitivity testing, bulbocavernosus testing, Hospital Depression and Anxiety Scale (HADS), Symptom Checklist (SCL-90-R), Groninger Arousability Scale (GAS), Visual Analogue Scale (VAS).

  1. Participants became more sexually active with their partners and with more satisfaction.
  2. Postoperative (11-24 months) glans sensation increased from absence to having sensations.
  3. All patients retained the preoperative ability to have an erection and ejaculations.
  4. Participants reported having more open and meaningful sexual relationships with their partners.

Courtois et al. 2011;

Canada

Individual cohort (aetiology)

N=89

Population: Men who achieved ejaculation with (n=50) or without (n=39) experiencing autonomic dysreflexia (AD).

Treatment: Ejaculation was obtained through natural stimulation, vibrostimulation or vibrostimulation combined with midodrine

(5-25 mg).

Outcome measures: Questionnaire inquiring about the physiological responses related to orgasm to test the hypothesis that orgasm is related to AD in individuals with SCI.

  1. Significantly more sensations were described at ejaculation than with sexual stimulation alone.
  2. Men with SCI who experienced AD at ejaculation reported significantly more cardiovascular, muscular, autonomic and dysreflexic responses than those who did not.

Borisoff et al. 2010;

Canada

Pre-post

N=3

Population: 3 males (mean age = 38, range 34-42) with SCI ≥1 year.

Treatment: Sexual self-stimulation while using a novel sensory substitution device that mapped the stroking motion of the hand to a congruous flow of electrocutaneous sensations on the tongue.Erection-enhancing drugs administered as needed.

Outcome measures: Solitary Masturbation Orgasm Questionnaire (Mah and Binik); SCI Ejaculation Questionnaire (Courtois et al.); Sexual Sensations Questionnaire (SSQ).

  1. Each participant reported an increased level of sexual pleasure compared to baseline after a few training sessions.
  2. No difference found on the ejaculation questionnaire scores.

Soler et al. 2008;

France

Pre-Post

N=158

Population: 158 subjects with SCI who failed to ejaculate from penile vibratory stimulation (PVS).

Treatment: Oral midodrine, starting at 7.5mg in subjects with tetraplegia and 15mg with paraplegia.

Outcome Measures: Ejaculation; orgasm.

  1. With midodrine, ejaculation was obtained in 102 men (64.6%).
  2. 93 (59%) subjects reported orgasm with both midodrine and PVS, compared to 14 patients with only PVS.
  3. Subjects with upper motor neuron injury and incomplete lesions experienced significantly more often orgasm.
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