PD-3-02-O3
SEXUAL FUNCTION IN STROKE PATIENTS
K. KAWAHIRA, N. TANAKA (Kagoshima University, Kagoshima, Japan)
We investigated the sexual problems of male and female stroke patients, to sole the problems to promote the sexual activities.
<Subjects and Methods> We studied 152 stroke patients (118 men 55±1l yrs, 34 women 55±8 yrs) living at home with their spouses and capable of sexual activity. Sexual functions were evaluated by means of interviews and questionnaires to the patients and their spouses separately. In 13 male patients morning erection was evaluated using a snap-gauge.
<Results> We divided the subjects into three groups according to age: below 49 yrs, 50-59 yrs, and older more than 60 years. Sexual desire was revived in 98, 76, and 60 % of male patients of each group, respectively. The men actually engaging in sexual intercourse after stroke were 78, 61, and 49 %, respectively. The dampening effect of age on sexual recovery was seen not only on sexual intercourse, but also on morning erections, orgasms, and ejaculations. Electric dysfunction in snap-gauge evaluation was found in 45 % of patients having no sexual intercourse after stroke. In female patients, recovery of sexual desire of each group was significantly lower than male patients, 29, 31 and 18 %, and 71, 56 and 45 % in sexual intercourse, respectively. The reason of unwilling or refusal sexual intercourse were, in facts, the luck of lubrication or pain in many patients rather than shame or anxiety.
<Conclusion> Many male patients recovers sexual activity after stroke. In female patients the problems seemed to be low lubrication provably due to vaginal atrophy.
PD-3-02-04
Sexuality and Disability: Missing Links
Trilok N. Monga; (Department of Physical Medicine and Rehabilitation, Veterans Affairs Medical Center, Baylor College of Medicine, Houston, Texas, USA)
Within recent years the definition and scope of sexuality have been changing. The main focus of this change has been to steer away from the traditional aspects of sexuality and to accept the wider, and perhaps unlimited boundaries of sex, love, and intimacy. However, the body of evidence that has been accumulated over the past 30 years regarding sexual functioning in people with disabilities, does not address the fundamental questions facing those patients who wish to form intimate relationships, have children, and be good parents. Sexual needs of physically disabled persons are still being ignored. A patient's sexual function and sexual adjustment within their functional limitations have not been studied systematically. Management guidelines are vague and too general. Moreover, data are lacking regarding outcome with any of the recommended interventions. These missing links have to be established. More research in the areas of love, intimacy, sexual expression and specific interventions in the management of sexual problems of stroke and traumatic brain injury patients needs to be carried out. Some of the other research issues include: methods of contraception, risks of contracting sexually transmitted diseases, issues of fertility, pregnancy, labor, and parenting.
Monga TN, Lefebvre KA: Sexuality: An Overview. In Sexuality and Disability; In, Trilok N. Monga (ED); Physical Medicine & Rehabilitation, State of the Arts Reviews, Philadelphia, Hanley & Belfus, 1995.
