Erectile function and depression in men after spinal cord injury

Introduction: Traumatic spinal cord injury (TSCI) is epidemic, mainly in economic and sexually active men. Among long term complications, sexual dysfunction (from diminished libido to ejaculatory disturbance) and depression are described problems related to TSCI. Intensity of complaints is linked to severity and medullary level of lesion. Objective: We aimed to evaluate depression and erectile function in heterosexual men after TSCI. Methods: Cross-sectional study involving previously sexual active men older than 18 years, which were enrolled in our reference hospitals by TSCI. Medullary level of TSCI was determined by International Standards for Neurological Classification of SCI and patients accomplished modified Beck Depression Inventory (BDI) and International Index of Erectile Function. Data were collected after at least six months from trauma and were analyzed in subgroups according variables. Descriptive statistics was performed with mean and confidence interval and bivariate analysis, with a confidence interval of 95%.The project was approved by the Ethics Committee on Human Research of the Health/ Federal University of Pernambuco) under number 41221414.5.0000.5208. Results: Forty-six men (34.3±9.5 years old) composed our sample. Incomplete medullary level above L2 was the most frequent lesion (30/46; 65%), followed by complete (15/46, 33%) and incomplete below L2 (1/46, 1%). Majority (40/46; 87%) had no depression in BDI, 3/46 (7%) had dysphoria and 3/46 had mild to moderate depression. 26/46 (57%) had capacity for psychogenic erection, and all had reflex erection. Complete SCI was associated with no psychogenic erection capacity (OR=9,4, 95%CI=2,1-41,6). Erectile dysfunction was slightly associated with dysphoria/depression (OR=1,8, 95%CI=0,3-11,0). All patients which scored mild to moderate depression had incomplete SCI above L2, but no statistical significance was obtained (OR=3,6, 95%CI=0,2-74,2). No depression in BDI was slight but not significantly associated with psychogenic erection (OR=1,4, 95%CI=0,2-7,5). Conclusion: Depression is infrequent after six months of the SCI and it is not associated with erectile function nor severity of lesion. Erectile dysfunction is associated with complete SCI.