Severity of Erectile Dysfunction in Thai Male Patients with Spinal Cord Injury


  • Raksina Yankiattipong Chakri Naruebodindra Medical Institute
  • Premsant Sangkum Division of Urology, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University
  • Napasakorn Komaratat Sirindhorn National Medical Rehabilitation Institute, Nonthaburi
  • Terdkiat Chayjarung Rajabhat Maha Sarakham University, Maha Sarakham, Thailand


spinal cord injuries, erectile dysfunction, prevalence, sex, male


Objectives: To examine severity of erectile dysfunction (ED) among Thai male patients with spinal cord injury (SCI) and relevant clinical data.

Study design: A retrospective study.

Setting: Sexual clinic, Sirindhorn National Medical Rehabilitation Institute, Nonthaburi, Thailand.

Subjects: Sixty-two Thai male patients with traumatic SCI.

Methods: The participants’ age, duration and level of SCI, relationship status before and after injury, family planning particularly their child wanting, bladder management and catheterization technique, the 5 International Index of Erectile Function (IIEF-5), frequency of sexual intercourse, history of taking oral medications for ED, and ejaculation were retrieved from their medical records.

Results: The mean age was 34 years old and duration of SCI was 50 months. Among all, 60% was complete paraplegia, 16% incomplete tetraplegia,13% complete tetraplegia and 11% incomplete paraplegia; 77% had partners.  Regarding bladder management, 11 (36%) used indwelling urinary catheter and had no sexual activity whereas 51 (64%) managed the bladder by themselves and 31 (61%) had regular sexual intercourse. Of those having regular sexual intercourse, 42% used phosphodiesterase type 5 (PDE5) inhibitors. Based on their IIEF-5 scores, 18 patients (35%) with regular sexual intercourse and not taking PDE5 inhibitor, were classified into 5 different severity levels: mild erectile dysfunction (33%), followed by mild to moderate (22%), moderate (22%), severe (17%) and no ED (5%). The prevalence of ED in sexually-active patients was 94% (17 out of 18 patients). 

Conclusion: About 35% of Thai SCI men attending a sexual clinic were sexually active without need of PDE5 inhibitor; and among them, one-third had mild erectile dysfunction.  All using indwelling urinary catheter had no sexual activity. Preserving their intimate relationship and the use of PDE inhibitors might help impel their sexual activity.

Keywords: spinal cord injuries, erectile dysfunction, prevalence, sex, male


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