Sexual Function and Dysfunction in Individuals with Spina Bifida: A Systematic Review.

Objective To conduct a systematic review of self-reported experiences of sexual function and dysfunction in individuals with spina bifida (SB). Materials and methods Medline, Embase, and Web of Science were systematically searched. Studies included contained self-reported data from SB patients on one or more of the following sexual function domains: genital sensitivity, orgasm, erectile function, ejaculation, lubrication, and/or dyspareunia. Two authors independently assessed eligibility, extracted data, and cross-checked results, with disagreements resolved by consensus. Studies included contained self-reported data from SB patients on one or more of the following sexual function domains: genital sensitivity, orgasm, erectile function, ejaculation, lubrication, and/or dyspareunia. Results Systematic search yielded 23 studies representing 1,441 patients (816 males, 625 females). Eight utilized questionnaires validated in non-SB adults; the remainder used semi-structured interviews and non-validated instruments. Eleven assessed dysfunction in both sexes, ten in males, and two in females. Erectile function and orgasm were the most commonly assessed outcomes in males and females respectively. 12-88% of males experienced erectile dysfunction; a majority (51-90%) reported normal ejaculatory function. Many females were unable to experience orgasm (28-63%). Conclusions Males with SB report significant erectile and ejaculatory dysfunction. Both sexes report impaired orgasms and genital sensitivity. SB-specific instruments assessing sexual dysfunction are needed in order to improve multidisciplinary care for this population.