REPRODUCTIVE UNDERSTANDING, SEXUAL FUNCTIONING AND TESTOSTERONE LEVELS IN MEN WITH SPINA-BIFIDA

Purpose: We assessed the sexual functioning and understanding in men w ith myelodysplasia. Materials and Methods: Of the 378 patients with my elodysplasia followed at our multidisciplinary clinic 170 are adults, including 58 men older than 18 years. A total of 57 men was available for interview. A questionnarie was administered to determine patient e ducational level, sexual understanding, sexual function and marital st atus, and serum testosterone levels were measured. Results: The majori ty of the patients learned about sexual reproduction from school class es with 48 (84%) having achieved a twelfth grade education or higher. A total of 41 patients (72%) accurately described the basic concepts o f reproductive physiology. Penile erections were experienced by 41 men (72%) including 27 (66%) who ejaculated with erection. Three patients ejaculated without erection. Sexual intercourse was attempted by 20 m en (35%). Of the 11 patients (19%) who attempted to father children 8 (14%) were successful. Twelve patients (21%) have been married, includ ing 2 who are divorced. Serum testosterone levels in 44 patients were normally distributed. Conclusions: Sexual reproductive understanding, and erectile and ejaculatory function are present in many men with mye lodysplasia. The level of the neurological lesion was not predictive o f erectile or ejaculatory function but it appears that reproductive po tential is favored by lower and less severe lesions. All but 1 of the 8 patients who fathered children had an L5 or sacral neurological leve l lesion, each was ambulatory and none had a ventriculoperitoneal shun t at the time of conception. These data may prove useful when counseli ng patients and their parents about eventual sexual performance.